,i  #aah? ,,congress  #a/ ,session  ,h4 
,r4 #fdcj  ,,9 ,,! ,,h\se ,,(           
,,repres5tatives  ,novemb] #ae1         
#bjbc,mrs4 ,mill] ( ,we/ ,virg9ia 7=    
h]self & ,ms4 ,sewell7 introduc$ !      
foll[+ bill2 :i* 0 ref]r$ to !          
,committee on ,ways & ,means  ,a ,,bill 
,to am5d title ,,xviii ( ! ,social      
,security ,act to ext5d ,m$ic>e-dep5d5t 
hospital & ,m$ic>e l[-volume hospital   
paym5ts1 & to direct ! ,comptroll]      
,g5]al ( ! ,unit$ ,/ates to c>ry out a  
report on ,m$ic>e rural hospital        
classifications4  #a4 ,%ort title ,?is  
,act may be cit$ z ! ,assi/ance = ,rural
 ,community ,hospitals ,act or ! ,,ar*  
,act4  #b4 ,ext5d+ ,m$ic>e-dep5d5t      
hospital & ,m$ic>e l[-volume hospital   
paym5ts  7a7 ,,mdh ext5sion  7#a7       
,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+ ,octob] #a1 #bjbd &
 ins]t+ ,octob] #a1 #bjbi2 &  7,b7 9    

clause 7ii77,,ii71 by /rik+ ,octob] #a1 
#bjbd & ins]t+ ,octob] #a1 #bjbi4  7#b7 
,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$-- 7i7 9 ! 
matt] prec$+ clause 7i71 by /rik+       
,octob] #a1 #bjbd & ins]t+ ,octob] #a1  
#bjbi 2 &  7ii7 9 clause 7iv71 by /rik+ 
fiscal ye> #bjbd & ins]t+ fiscal ye>    
#bjbi14  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+ fiscal ye> #bjbd & ins]t+ fiscal  
ye> #bjbi14  7b7 ,,lvh ext5sion ,section
 #ahhf7;d77#ab7 ( ! ,social ,security   
,act 7#db ,u4,s4,c4 #acieww7d77#ab77 is 
am5d$-- 7#a7 9 subp>agraph 7,c77i7--    
7,a7 9 ! matt] prec$+ subclause 7,i71 by
 /rik+ ?r\gh #bjbd & ins]t+ ?r\gh #bjbi2
  7,b7 9 subclause 7,,iii71 by /rik+    
?r\gh #bjbd & ins]t+ ?r\gh #bjbi2 &     
7,c7 9 subclause 7,,iv71 by /rik+ #bjbe 

& ins]t+ #bjcj2 &  7#b7 9 subp>agraph   
7,d7-- 7,a7 9 ! matt] prec$+ clause 7i71
 by /rik+ ?r\gh #bjbd & ins]t+ ?r\gh    
#bjbi2 &  7,b7 9 clause 7ii71 by /rik+  
?r\gh #bjbd & ins]t+ ?r\gh #bjbi4  #c4  
,,gao report on ,m$ic>e rural hospital  
classifications ,n lat] ?an #ahj days   
aft] ! date ( ! enactm5t ( ?is ,act1 !  
,comptroll] ,g5]al ( ! ,unit$ ,/ates    
%all submit to ,congress a report on    
,m$ic>e rural hospital classifications t
 includes ! foll[+ in=mation3 7#a7 ,!   
total numb] ( hospitals t1 ) respect to 
any ( ! #e fiscal ye>s prec$+ su* date (
 enactm5t1 _h any ( ! foll[+            
classifications3 7,a7 ,classification z 
a critical access hospital 7z def9$ 9   
section #ahfa7mm77#a7 ( ! ,social       
,security ,act 7#db ,u4,s4,c4           
#aciex7mm77#a7774  7,b7 ,classification 
z a rural em]g5cy hospital 7z def9$ 9   
section #ahfa7kkk77#b7 ( su* ,act 7#db  
,u4,s4,c4 #aciex7kkk77#b7774  7,c7      
,classification z a rural ref]ral c5t]  
7z describ$ 9 section #ahhf7;d77#e77;,c7

 ( su* ,act 7#db ,u4,s4,c4              
#acieww7d77#e77;,c774  7,d7             
,classification z a sole community      
hospital 7z def9$ 9 section             
#ahhf7;d77#e77;,d77iii7 ( su* ,act 7#db 
,u4,s4,c4 #acieww7d77#e77;,d77iii7774   
7,e7 ,classification z a m$ic>e-dep5d5t1
 small rural hospital 7z def9$ 9 section
 #ahhf7;d77#e77;,g77iv7 ( su* ,act 7#db 
,u4,s4,c4 #acieww7d77#e77;,g77iv7774    
7,f7 ,classification z a l[-volume      
hospital 7z def9$ 9 section             
#ahhf7;d77#ab77;,c77i7 ( su* ,act 7#db  
,u4,s4,c4 #acieww7d77#ab77;,c77i7774    
7#b7 ,an analysis ( ! ext5t to :i* !re  
is ov]lap betwe5 ! crit]ia = any two or 
m ( ! classifications describ$ 9        
p>agraph 7#a74  7#c7 ,recomm5dations =--
 7,a7 simplification ) respect to su*   
classifications & any su* ov]lap2 &     
7,b7 *anges ) respect to ! crit]ia = su*
 classifications t w\ld promote f9ancial
 su/a9ability = rural hospitals &       
improve access to heal? c>e =           
individuals 9 rural areas4  7#d7 ,!     

project$ effects ( all[+ sole community 
hospitals 7z describ$ 9 p>agraph        
7#a77;,d77 & m$ic>e-dep5d5t1 small rural
 hospitals 7z describ$ 9 p>agraph       
7#a77;,e77 to use a co/ report+ p]iod   
beg9n+ dur+ fiscal ye> #bjai = ! purpose
 ( calculat+ adju/$ paym5ts "u section  
#ahhf7;d77#e7 ( ! ,social ,security ,act
 7#db ,u4,s4,c4 #acieww7d77#e774