,,ii  #aaf? ,,congress  #b;d ,session   
,s4 #dacg  ,,9 ,,! ,,s5ate ,,( ,,!      
,,unit$ ,,/ates  ,july #a1 #bjbj,mr4    
,s*atz 7= himself1 ,ms4 ,murk[ski1 ,ms4 
,hirono1 & ,mr4 ,sullivan7 introduc$ !  
foll[+ bill2 :i* 0 read twice & ref]r$  
to ! ,committee on ,f9ance  ,a ,,bill   
,to am5d title ,,xviii ( ! ,social      
,security ,act to au?orize ! ,secret>y (
 ,heal? & ,human ,s]vices to make       
adju/m5ts to paym5t rates = skill$ nurs+
 facilities "u ! ,m$ic>e program to     
acc\nt = c]ta9 unique circum/ances4  #a4
 ,%ort title ,?is ,act may be cit$ z !  
,equitable ,paym5ts = ,nurs+ ,facilities
 ,act ( #bjbj4  #b4 ,au?oriz+ !         
,secret>y ( ,heal? & ,human ,s]vices to 
make adju/m5ts to paym5t rates = skill$ 
nurs+ facilities "u ! ,m$ic>e program to
 acc\nt = c]ta9 unique circum/ances     
,section #ahhh7;e77#d77;,g7 ( ! ,social 
,security ,act 7#db ,u4,s4,c4           
#acieyy7e77#d77;,g77 is am5d$ by add+ at
 ! end ! foll[+ new clause3  7iv7       
,adju/m5t = unique circum/ances ,!      

,secret>y may provide = su* adju/m5ts z 
det]m9$ appropriate by ! ,secret>y to   
take into acc\nt ! unique circum/ances (
 skill$ nurs+ facilities locat$ 9       
,alaska or ,hawaii4  4