,i  #aag? ,,congress  #a/ ,session  ,h4 
,r4 #dhi  ,,9 ,,! ,,h\se ,,(            
,,repres5tatives  ,janu>y #be1 #bjba,ms4
 ,/efanik 7= h]self & ,mr4 ,delgado7    
introduc$ ! foll[+ bill2 :i* 0 ref]r$ to
 ! ,committee on ,ways & ,means  ,a     
,,bill  ,to am5d title ,,xviii ( !      
,social ,security ,act to cl>ify !      
application ( ! #ae-mile second>y road  
di/ance requirem5t ) respect to         
previ\sly designat$ critical access     
hospitals "u ! ,m$ic>e program4  #a4    
,%ort title ,?is ,act may be cit$ z !   
,protect+ ,rural ,access to ,c>e ,act4  
#b4 ,cl>ify+ ! application ( ! #ae-mile 
second>y road di/ance requirem5t )      
respect to previ\sly designat$ critical 
access hospitals ,section #ahbj7;h7 ( ! 
,social ,security ,act 7#db ,u4,s4,c4   
#acie;i-#d7;h77 is am5d$ by add+ at !   
end ! foll[+ new p>agraph3  7#d7        
,application ( #ae-mile second>y roads  
crit]ia ,9 ! case ( a facility t 0      
designat$ z a critical access hospital  
be=e ,july #ca1 #bjae1 9 apply+ !       

crit]ia = su* designation specifi$ 9    
clause 7i7 ( subsection 7c77#b77;,b71 a 
,/ate 7& ! ,secret>y7 %all s apply su*  
crit]ia1 ins(> z su* crit]ia relates to 
a facility locat$ 9 an area ) only      
second>y roads available1 us+ su*       
guidance & regulations z 7 9 effect on  
,july #cj1 #bjae4  4  #c4 ,requirem5t = 
public notice & comm5t p]iod = any      
guidance or regulation relat+ to        
designation crit]ia = critical access   
hospitals  7a7 ,9 g5]al ,) respect to   
any guidance or regulation issu$ by !   
,secret>y ( ,heal? & ,human ,s]vices 79 
?is section ref]r$ to z ! ,secret>y7 on 
or aft] ! date ( ! enactm5t ( ?is ,act  
relat+ to ! crit]ia = designation ( a   
facility z a critical access hospital 7z
 specifi$ 9 section #ahbj7;c77#b77;,b7 (
 ! ,social ,security ,act 7#db ,u4,s4,c4
 #acie;i-#d7;c77#b77;,b7771 su* guidance
 or regulation %all n take effect prior 
to ! expiration ( a notice & comm5t     
p]iod ( n less ?an #fj days "u :i* !    
public is giv5 ! opportunity to comm5t  

on su* guidance or regulation & !       
,secret>y evaluates any su* comm5ts4    
7b7 ,retroactive application to guidance
 relat+ to application ( ! #ae-,mile    
second>y road di/ance requirem5t ,9     
apply+ ! crit]ia describ$ 9 subsection  
7a71 a ,/ate 7& ! ,secret>y7 %all s     
apply su* crit]ia1 ins(> z su* crit]ia  
relates to a facility locat$ 9 an area )
 only second>y roads available1 us+ su* 
guidance & regulations z 7 9 effect on  
,july #cj1 #bjae1 until1 subject to     
p>agraph 7#d7 ( section #ahbj7;h7 ( !   
,social ,security ,act 7z add$ by       
section #b71 su* "t z ! ,secret>y issues
 guidance or regulations 9 accordance ) 
su* subsection4