,i  #aag? ,,congress  #a/ ,session  ,h4 
,r4 #ahch  ,,9 ,,! ,,h\se ,,(           
,,repres5tatives  ,m>* #aa1 #bjba ,mr4  
,luetkemey] 7= himself1 ,mr4 ,sessions1 
,mr4 ,jackson1 ,mr4 ,arr+ton1 ,mr4      
,gue/1 & ,mr4 ,long7 introduc$ ! foll[+ 
bill2 :i* 0 ref]r$ to ! ,committee on   
,en]gy & ,comm]ce1 & 9 addition to !    
,committee on ,ways & ,means1 = a p]iod 
to be subsequ5tly det]m9$ by ! ,speak]1 
9 ea* case = consid]ation ( su*         
provisions z fall )9 ! jurisdiction ( ! 
committee conc]n$  ,a ,,bill  ,to am5d  
title ,,xviii ( ! ,social ,security ,act
 to improve rural heal? cl9ic paym5ts1 &
 = o!r purposes4  #a4 ,%ort title ,?is  
,act may be cit$ z ! ,af=dable ,access  
to ,rural ,heal? ,c>e ,act4  #b4        
,improv+ rural heal? cl9ic paym5ts  7a7 
,9 g5]al ,section #ahcc7;f7 ( ! ,social 
,security ,act 7#db ,u4,s4,c4 #aciel7f77
 is am5d$--  7#a7 by add+ at ! end !    
foll[+ new p>agraphs3  7#d7 ,exception  
,9 e/abli%+ limits "u subsection 7a7 on 
paym5t = rural heal? cl9ic s]vices      

provid$ by rural heal? cl9ics :i*       
submits to ! ,secret>y a c]tification t 
! hospital has a b9d+ writt5 agreem5t ) 
an outside unrelat$ p>ty = ! con/ruction
 or pur*ase ( su* rural heal? cl9ic be=e
 ,m>* #cj1 #bjba1 ! ,secret>y %all--    
7,a7 dur+ ! fir/ ye> dur+ :i* su* rural 
heal? cl9ic furni%es su* s]vices1 make  
paym5ts to su* rural heal? cl9ic )\t !  
application ( su* limits2 &  7,b7 dur+  
any subsequ5t ye>1 make paym5ts 9       
accordance ) ?is subsection4  7#e7      
,audit ,n lat] ?an #fj days aft] ! date 
( ! enactm5t ( ?is p>agraph1 ! ,secret>y
 %all audit ! compliance ) requirem5ts (
 p>agraph 7#d7 ) respect to ea* rural   
heal? cl9ic to :i* su* p>agraph applies4
 ,if ! ,secret>y f9ds z a result ( an   
audit "u ?is clause t ! applicable      
requirem5ts 7 n met ) respect to su*    
rural heal? cl9ic1 ! rural heal? cl9ic  
%all receive paym5ts "u ?is subsection  
not)/&+ su* p>agraph4  4  7b7           
,utilization ( ,m$ic>e ,enrollm5t       
,application =m ,! ,secret>y ( ,heal? & 

,human ,s]vices %all utilize ,=m ,,cms  
#hee;,a 7or any successor ,m$ic>e       
,enrollm5t ,application =m7 to review ! 
eligibility ( rural heal? cl9ics 7z     
def9$ 9 section #ahfa7;aa77#b7 ( !      
,social ,security ,act 7#db ,u4,s4,c4   
#aciex7aa77#b777 to receive paym5ts     
pursuant to ! mid-build exception       
describ$ 9 section #ahcc7;f77#d7 ( su*  
,act 7#db ,u4,s4,c4 #aicel7f77#d774  7c7
 ,report ,n lat] ?an #abj days aft] !   
date ( ! enactm5t ( ?is ,act1 !         
,secret>y ( ,heal? & ,human ,s]vices    
%all submit to ,congress a report on !  
f9d+s ( ! audit describ$ 9 p>agraph 7#e7
 ( section #ahcc7;f7 ( ! ,social        
,security ,act 7#db ,u4,s4,c4           
#aicel7f774