,i  #aag? ,,congress  #b;d ,session  ,h4
 ,r4 #icib  ,,9 ,,! ,,h\se ,,(          
,,repres5tatives  ,decemb] #a1 #bjbb,mr4
 ,meus] 7= himself1 ,ms4 ,wild1 & ,mr4  
,mann7 introduc$ ! foll[+ bill2 :i* 0   
ref]r$ to ! ,committee on ,ways & ,means
  ,a ,,bill  ,to am5d title ,,xviii ( ! 
,social ,security ,act to ext5d !       
,m$ic>e-dep5d5t hospital program & to   
update ! calculation ( ! hospital       
specific rate = su* hospitals4  #a4     
,%ort title ,?is ,act may be cit$ z !   
,fairness = ,rural ,tea*+ ,hospitals    
,act ( #bjbb4  #b4 ,ext5sion ( !        
m$ic>e-dep5d5t hospital program  7a7    
,ext5sion ( paym5t me?odology ,section  
#ahhf7;d77#e77;,g7 ( ! ,social ,security
 ,act 7#db ,u4,s4,c4                    
#acieww7d77#e77;,g77 is am5d$-- 7#a7 9  
clause 7i71 by /rik+ ,decemb] #ag1 #bjbb
 & ins]t+ ,septemb] #cj1 #bjbg2 &  7#b7 
9 clause 7ii77,,ii71 by /rik+ 1 & be=e  
,decemb] #ag1 #bjbb & ins]t+ 1 & be=e   
,septemb] #cj1 #bjbg4  7b7 ,con=m+      
am5dm5ts  7#a7 ,ext5sion ( t>get am\nt  

,section #ahhf7;b77#c77;,d7 ( ! ,social 
,security ,act 7#db ,u4,s4,c4           
#acieww7b77#c77;,d77 is am5d$-- 7,a7 9 !
 matt] prec$+ clause 7i71 by /rik+      
,decemb] #ag1 #bjbb & ins]t+ ,septemb]  
#cj1 #bjbg2 &  7,b7 9 clause 7iv71 by   
/rik+ #bjbb & ins]t+ #bjbg4  7#b7       
,p]mitt+ hospitals to decl9e            
reclassification ,section #aceja7;e77#b7
 ( ! ,omnibus ,budget ,reconciliation   
,act ( #aiic 7#db ,u4,s4,c4 #acieww     
note7 is am5d$ by /rik+ #bjbb & ins]t+  
#bjbg4  #c4 ,update to calculation (    
hospital specific rate = m$ic>e-dep5d5t 
hospitals ,section #ahhf7;d77#e77;,g7 ( 
! ,social ,security ,act 7#db ,u4,s4,c4 
#acieww7d77#e77;,g771 z am5d$ by section
 #b1 is fur!r am5d$ by ins]t+ aft]      
clause 7iii7 ! foll[+3 ,= purposes (    
clause 7ii77,,ii71 9 calculat+ ! am\nt  
det]m9$ "u p>agraph 7#a77;,a77iii7 )    
respect to dis*>ges occurr+ on or aft]  
,janu>y #a1 #bjbc1 ! ,secret>y %all     
exclude an e/imate ( indirect m$ical    
co/s 9 accordance ) ! requirem5ts       

specifi$ 9 p>agraph 7#b77;,c77i74 4