,9 ! ,s5ate ( ! ,unit$ ,/ates1  ,m>*    
#be1 #bjba4  ,am5dm5t3  ,t ! bill f !   
,h\se ( ,repres5tatives 7,h4,r4 #ahfh7  
entitl$ ,an ,act to prev5t across-!-bo>d
 direct sp5d+ cuts1 & = o!r purposes41 d
 pass ) ! foll[+ ,/rike all aft] !      
enact+ clause & ins]t ! foll[+3 #a4     
,ext5sion ( tempor>y susp5sion ( m$ic>e 
seque/ration  7a7 ,ext5sion  7#a7 ,9    
g5]al ,section #cgji7;a7 ( division ,a (
 ! ,,c>es ,act 7#b ,u4,s4,c4 #ija;a     
note7 is am5d$ by /rik+ ,m>* #ca1 #bjba 
& ins]t+ ,decemb] #ca1 #bjba4  7#b7     
,effective date ,! am5dm5t made by      
p>agraph 7#a7 %all take effect z if     
enact$ z "p ( ! ,,c>es ,act 7,public    
,law #aaf-acf74  7b7 ,(fset ,section    
#bea;,a7#f77;,c7 ( ! ,balanc$ ,budget & 
,em]g5cy ,deficit ,control ,act ( #aihe 
7#b ,u4,s4,c4 #ija;a7#f77;,c77 is       
am5d$-- 7#a7 9 clause 7i7-- 7,a7 by     
/rik+ fir/ #f mon?s & ins]t+ fir/ #e    
#a_/b mon?s2  7,b7 by /rik+ #d4j p]c5t &
 ins]t+ #b4j p]c5t2 &  7,c7 by /rik+ &  
at ! end2  7#b7 9 clause 7ii7-- 7,a7 by 

/rik+ second #f mon?s & ins]t+ #f-mon?  
p]iod beg9n+ on ! day aft] ! la/ day ( !
 p]iod describ$ 9 clause 7i72 &  7,b7 by
 /rik+ #j4j p]c5t4 & ins]t+ #d4j p]c5t2 
&2 &  7#c7 by add+ at ! end ! foll[+3   
7iii7 ) respect to ! rema9+ #a_/b mon? 9
 :i* su* ord] is s effective = su*      
fiscal ye>1 ! paym5t r$uction %all be   
#j4j p]c5t4  4  #b4 ,te*nical           
corrections  7a7 ,rural heal? cl9ic     
paym5ts  7#a7 ,9 g5]al ,section         
#ahcc7;f77#c7 ( ! ,social ,security ,act
 7#db ,u4,s4,c4 #aciel7f77#c77 is       
am5d$-- 7,a7 9 subp>agraph 7,a7-- 7i7 9 
clause 7i71 by /rik+ subclauses 7,i7 &  
7,,ii7 & ins]t+ ! foll[+3  7,i7 )       
respect to a rural heal? cl9ic t _h a p]
 visit paym5t am\nt e/abli%$ = s]vices  
furni%$ 9 #bjbj-- 7aa7 ! p] visit paym5t
 am\nt applicable to su* rural heal?    
cl9ic = rural heal? cl9ic s]vices       
furni%$ 9 #bjbj1 increas$ by ! p]c5tage 
increase 9 ! ,,mei applicable to prim>y 
c>e s]vices furni%$ z ( ! fir/ day (    
#bjba2 or  7bb7 ! limit describ$ 9      

p>agraph 7#b77;,a72 &  7,,ii7 ) respect 
to a rural heal? cl9ic t did n h a p]   
visit paym5t am\nt e/abli%$ = s]vices   
furni%$ 9 #bjbj-- 7aa7 ! p] visit paym5t
 am\nt applicable to su* rural heal?    
cl9ic = rural heal? cl9ic s]vices       
furni%$ 9 #bjba2 or  7bb7 ! limit       
describ$ 9 p>agraph 7#b77;,a72 &  2 &   
7ii7 9 clause 7ii77,i71 by /rik+ "u     
clause 7i77,i7 & ins]t+ "u subclause    
7,i7 or 7,,ii7 ( clause 7i71 z          
applicable12 &  7,b7 by /rik+           
subp>agraph 7,b7 & ins]t+ ! foll[+3     
7,b7 ,a rural heal? cl9ic describ$ 9 ?is
 subp>agraph is a rural heal? cl9ic t-- 
7i7 z ( ,decemb] #ca1 #bjbj1 0 9 a      
hospital ) less ?an #ej b$s & aft] su*  
date su* hospital cont9ues to h less ?an
 #ej b$s 7n tak+ into acc\nt any        
increase 9 ! numb] ( b$s pursuant to a  
waiv] "u subsection 7b77#a77;,a7 (      
section #aace dur+ ! em]g5cy p]iod      
describ$ 9 subsection 7g77#a77;,b7 ( su*
 section72 &  7ii7 7,i7 z ( ,decemb]    
#ca1 #bjbj1 0 enroll$ "u section        

#ahff7;j7 7includ+ tempor>y enrollm5t   
dur+ su* em]g5cy p]iod = su* em]g5cy    
p]iod72 or  7,,ii7 submitt$ an          
application = enrollm5t "u section      
#ahff7;j7 7or a reque/ = su* a tempor>y 
enrollm5t = su* em]g5cy p]iod7 t 0      
receiv$ n lat] ?an ,decemb] #ca1 #bjbj4 
4  7#b7 ,effective date ,! am5dm5ts made
 by ?is subsection %all take effect z if
 includ$ 9 ! enactm5t ( ! ,consolidat$  
,appropriations ,act1 #bjba 7,public    
,law #aaf-bfj74  7b7 ,additional am\nt =
 c]ta9 hospitals ) high disproportionate
 %>e ,effective z if includ$ 9 !        
enactm5t ( section #bjc7;a7 ( title ,,ii
 ( division ,,cc ( ,public ,law         
#aaf-bfj1 subsection 7g7 ( section #aibc
 ( ! ,social ,security ,act 7#db        
,u4,s4,c4 #acifr-#d71 z am5d$ by su*    
section1 is am5d$ by add+ at ! end !    
foll[+3  7#c7 ,cont9u$ application (    
gr&fa!r$ transition rule ,not)/&+       
p>agraph 7#b7 ( ?is subsection 7z 9     
effect on ,octob] #a1 #bjba71 p>agraph  
7#b7 ( ?is subsection 7z 9 effect on    

,septemb] #cj1 #bjba1 & z appli$ "u     
section #dgba7;e7 ( ! ,balanc$ ,budget  
,act ( #aiig1 & am5d$ by section #fjg ( 
! ,m$ic>e1 ,m$icaid1 & ,,s*ip ,balanc$  
,budget ,ref9em5t ,act ( #aiii 7,public 
,law #ajf-aac77 %all apply 9 det]m9+    
:e!r a paym5t adju/m5t = a hospital 9 a 
,/ate ref]5c$ 9 section #dgba7;e7 ( !   
,balanc$ ,budget ,act ( #aiig dur+ a    
,/ate fiscal ye> %all be consid]$       
consi/5t ) subsection 7c74  4  ,secret>y