,i  #aagth ,,congress  #b;d ,session    
,h4 ,r4 #hefe  ,,in ,,the ,,house ,,of  
,,representatives  ,july #bh1 #bjbb,mr4 
,graves of ,missouri introduced the     
following bill2 which was referred to   
the ,committee on ,ways and ,means  ,a  
,,bill  ,to amend title ,,xviii of the  
,social ,security ,act to permanently   
extend the ,medicare-dependent hospital 
and low-volume hospital programs under  
the ,medicare program4  #a4 ,short title
 ,this ,act may be cited as the ,rural  
,hospital ,extensions for ,low-volume   
,programs ,act of #bjbb or the ,rural   
,,help ,act of #bjbb4  #b4 ,permanently 
extending the ,medicare-dependent       
hospital and low-volume hospital        
programs under the ,medicare program    
7a7 ,extension of the                   
,medicare-,dependent hospital 7,,mdh7   
program  7#a7 ,extension of payment     
methodology ,section #ahhf7;d77#e77;,g7 
of the ,social ,security ,act 7#db      
,u4,s4,c4 #acieww7d77#e77;,g77 is       
amended-- 7,a7 in clause 7i71 by        

striking 1 and before ,october #a1      
#bjbb2 and  7,b7 in clause 7ii77,,ii71  
by striking 1 and before ,october #a1   
#bjbb4  7#b7 ,conforming amendments     
7,a7 ,extension of target amount        
,section #ahhf7;b77#c77;,d7 of the      
,social ,security ,act 7#db ,u4,s4,c4   
#acieww7b77#c77;,d77 is amended-- 7i7 in
 the matter preceding clause 7i71 by    
striking 1 and before ,october #a1      
#bjbb2 and  7ii7 in clause 7iv71 by     
striking through fiscal year #bjbb and  
inserting or a subsequent fiscal year4  
7,b7 ,permitting hospitals to decline   
reclassification ,section #aceja7;e77#b7
 of the ,omnibus ,budget ,reconciliation
 ,act of #aiic 7#db ,u4,s4,c4 #acieww   
note7 is amended by striking fiscal year
 #bjjj through fiscal year #bjbb and    
inserting a subsequent fiscal year4  7b7
 ,extension of the increased payments   
under the medicare low-,volume hospital 
program ,section #ahhf7;d77#ab7 of the  
,social ,security ,act 7#db ,u4,s4,c4   
#acieww7d77#ab77 is amended-- 7#a7 in   

subparagraph 7,b7-- 7,a7 in the header1 
by inserting for fiscal years #bjje     
through #bjaj after increase2 and  7,b7 
in the matter preceding clause 7i71 by  
striking and for discharges occurring in
 fiscal year #bjbc and subsequent fiscal
 years2  7#b7 in subparagraph 7,c77i7-- 
7,a7 in the matter preceding subclause  
7,i71 by striking through #bjbb and     
inserting and each subsequent fiscal    
year2  7,b7 in subclause 7,,ii71 by     
adding at the end and2  7,c7 in         
subclause 7,,iii7-- 7i7 by striking     
fiscal years #bjai through #bjbb and    
inserting fiscal year #bjai and each    
subsequent fiscal year2 and  7ii7 by    
striking 2 and and inserting a period2  
and  7,d7 by striking subclause 7,,iv72 
and  7#c7 in subparagraph 7,d7-- 7,a7 by
 amending the header to read as follows3
 ,applicable percentage increase        
beginning with fiscal year #bjba2  7,b7 
in the matter preceding clause 7i71 by  
striking fiscal years #bjaa through     
#bjbb and inserting fiscal year #bjai   

and each subsequent fiscal year2 and    
7,c7 in clause 7ii71 by striking each of
 fiscal years #bjai through #bjbb and   
inserting fiscal year #bjai and each    
subsequent fiscal year4