,i  #aah? ,,congress  #b;d ,session  ,h4
 ,r4 #iabh  ,,9 ,,! ,,h\se ,,(          
,,repres5tatives  ,july #bd1 #bjbd,mr4  
,sablan 7= himself & ,mr4 ,moylan7      
introduc$ ! foll[+ bill2 :i* 0 ref]r$ to
 ! ,committee on ,en]gy & ,comm]ce1 & 9 
addition to ! ,committees on ,ways &    
,means1 & ! ,budget1 = a p]iod to be    
subsequ5tly det]m9$ by ! ,speak]1 9 ea* 
case = consid]ation ( su* provisions z  
fall )9 ! jurisdiction ( ! committee    
conc]n$  ,a ,,bill  ,to am5d title      
,,xviii ( ! ,social ,security ,act to   
e/abli% a designation = t]ritorial      
safety net hospitals1 & = o!r purposes4 
#a4 ,%ort title ,?is ,act may be cit$ z 
! ,support+ ,t]ritorial ,safety ,net    
,hospitals ,act4  #b4 ,designation =    
t]ritorial safety net hospitals  7a7    
,t]ritorial safety net hospital def9$   
,section #ahfa ( ! ,social ,security    
,act 7#db ,u4,s4,c4 #aciex7 is am5d$ by 
add+ at ! end ! foll[+ new subsection3  
7nnn7 ,t]ritorial safety net hospital   
7#a7 ,! t]m t]ritorial safety net       

hospital means a hospital 7z def9$ 9    
subsection 7e77 t is locat$ 9 ! ,nor!rn 
,m>iana ,isl&s1 ,am]ican ,samoa1 ,guam1 
or ! ,virg9 ,isl&s4  7#b7 ,! t]m        
inpati5t t]ritorial safety net hospital 
s]vices means items & s]vices1 furni%$  
to an inpati5t ( a t]ritorial safety net
 hospital by su* facility1 t w\ld be    
inpati5t hospital s]vices if furni%$ to 
an inpati5t ( a hospital by a hospital4 
7#c7 ,! t]m outpati5t t]ritorial safety 
net hospital s]vices means m$ical & o!r 
heal? s]vices furni%$ by a t]ritorial   
safety net hospital on an outpati5t     
basis4  4  7b7 ,paym5t = inpati5t       
t]ritorial safety net hospital s]vices  
7#a7 ,9 g5]al ,section #ahad ( ! ,social
 ,security ,act 7#db ,u4,s4,c4 #acie;f7 
is am5d$-- 7,a7 9 subsection 7b71 by    
ins]t+ o!r ?an a t]ritorial safety net  
hospital provid+ inpati5t t]ritorial    
safety net hospital s]vices1 aft]       
critical access hospital provid+        
inpati5t critical access hospital       
s]vices12 &  7,b7 by add+ at ! end !    

foll[+ new subsection3  7m7 ,paym5t =   
inpati5t t]ritorial safety net hospital 
s]vices ,! am\nt ( paym5t "u ?is "p =   
inpati5t t]ritorial safety net hospital 
s]vices is equal to #aja p]c5t ( !      
reasonable co/s ( ! t]ritorial safety   
net hospital 9 provid+ su* s]vices4  4  
7#b7 ,scope ( b5efits ,section          
#ahab7;a77#a7 ( ! ,social ,security ,act
 7#db ,u4,s4,c4 #acie;d7a77#a77 is am5d$
 by /rik+ or inpati5t critical access   
hospital s]vices & ins]t+ 1 inpati5t    
critical access hospital s]vices1 or    
inpati5t t]ritorial safety net hospital 
s]vices4  7#c7 ,d$uctibles & co9surance 
,section #ahac ( ! ,social ,security    
,act 7#db ,u4,s4,c4 #acie;e7 is am5d$-- 
7,a7 9 subsection 7a77#a71 by /rik+ or  
inpati5t critical access hospital       
s]vices ea* place x appe>s & ins]t+ 1   
inpati5t critical access hospital       
s]vices1 or inpati5t t]ritorial safety  
net hospital s]vices2 &  7,b7 9         
subsection 7b77#c7-- 7i7 9 subp>agraph  
7,a71 by /rik+ or inpati5t critical     

access hospital s]vices & ins]t+ 1      
inpati5t critical access hospital       
s]vices1 or inpati5t t]ritorial safety  
net hospital s]vices2 &  7ii7 9         
subp>agraph 7,b71 by ins]t+ 1 inpati5t  
t]ritorial safety net hospital s]vices1 
aft] inpati5t critical access hospital  
s]vices4  7#d7 ,paym5t to provid]s (    
s]vices ,section #ahae7;e77#b7 ( !      
,social ,security ,act 7#db ,u4,s4,c4   
#acie;g7e77#b77 is am5d$-- 7,a7 9       
subp>agraph 7,d71 by /rik+ & at ! end2  
7,b7 9 subp>agraph 7,e71 by ins]t+ &    
aft] ! semicolon at ! end2 &  7,c7 by   
add+ at ! end ! foll[+ new subp>agraph3 
7,f7 inpati5t t]ritorial safety net     
hospital s]vices2  4  7#e7 ,adm9i/ration
 ( "p ,a ,section #ahaf7;c77#b77;,c7 ( !
 ,social ,security ,act 7#db ,u4,s4,c4  
#acie;h7c77#b77;,c77 is am5d$ by ins]t+ 
t]ritorial safety net hospital1 aft]    
critical access hospital14  7c7 ,paym5t 
= outpati5t t]ritorial safety net       
hospital s]vices  7#a7 ,9 g5]al ,section
 #ahcd ( ! ,social ,security ,act 7#db  

,u4,s4,c4 #aciem7 is am5d$ by add+ at ! 
end ! foll[+ new subsection3  7aa7      
,paym5t = outpati5t t]ritorial safety   
net hospital s]vices  7#a7 ,9 g5]al ,!  
am\nt ( paym5t = outpati5t t]ritorial   
safety net hospital s]vices ( a         
t]ritorial safety net hospital is equal 
to #aja p]c5t ( ! reasonable co/s ( !   
hospital 9 provid+ su* s]vices1 unless !
 hospital makes ! election "u p>agraph  
7#b74  7#b7 ,election ( co/-bas$        
hospital outpati5t s]vice paym5t plus   
fee s*$ule = pr(essional s]vices ,a     
t]ritorial safety net hospital may elect
 to be paid = outpati5t t]ritorial      
safety net hospital s]vices am\nts equal
 to ! sum ( ! foll[+1 less ! am\nt t su*
 hospital may *>ge z describ$ 9 section 
#ahff7;a77#b77;,a73 7,a7 ,facility fee  
,) respect to facility s]vices1 n       
includ+ any s]vices = :i* paym5t may be 
made "u subp>agraph 7,b71 #aja p]c5t ( !
 reasonable co/s ( ! t]ritorial safety  
net hospital 9 provid+ su* s]vices4     
7,b7 ,fee s*$ule = pr(essional s]vices  

,) respect to pr(essional s]vices       
o!rwise includ$ )9 outpati5t t]ritorial 
safety net hospital s]vices1 #aae p]c5t 
( su* am\nts z w\ld o!rwise be paid "u  
?is "p if su* s]vices 7 n includ$ 9     
outpati5t t]ritorial safety net hospital
 s]vices4 ,subsections 7x7 & 7y7 (      
section #ahcc %all n be tak5 into acc\nt
 9 det]m9+ ! am\nts t w\ld o!rwise be   
paid pursuant to ! prec$+ s5t5ce4  ,!   
,secret>y may n require1 z a condition =
 apply+ subp>agraph 7,b7 ) respect to a 
t]ritorial safety net hospital1 t ea*   
physician or o!r practition] provid+    
pr(essional s]vices 9 ! hospital mu/    
assign bill+ rights ) respect to su*    
s]vices1 except t su* subp>agraph %all n
 apply to ^? physicians & practition]s  
:o h n assign$ su* bill+ rights4  7#c7  
,disreg>d+ *>ges ,! paym5t am\nts "u ?is
 subsection %all be det]m9$ )\t reg>d to
 ! am\nt ( ! cu/om>y or o!r *>ge4  7#d7 
,treatm5t ( cl9ical diagno/ic laboratory
 s]vices ,no co9surance1 d$uctible1     
copaym5t1 or o!r co/-%>+ o!rwise        

applicable "u ?is "p %all apply )       
respect to cl9ical diagno/ic laboratory 
s]vices furni%$ z an outpati5t          
t]ritorial safety net hospital s]vice4  
,no?+ 9 ?is title %all be con/ru$ z     
provid+ = paym5t = cl9ical diagno/ic    
laboratory s]vices furni%$ z "p (       
outpati5t t]ritorial safety net hospital
 s]vices1 o!r ?an on ! basis describ$ 9 
?is subsection4 ,= purposes ( ! prec$+  
s5t5ce & section #ahfa7nnn77#c71 cl9ical
 diagno/ic laboratory s]vices furni%$ by
 a t]ritorial safety net hospital %all  
be treat$ z be+ furni%$ z "p ( outpati5t
 critical access s]vices )\t reg>d to   
:e!r ! individual ) respect to :om su*  
s]vices are furni%$ is physically pres5t
 9 ! t]ritorial safety net hospital1 or 
9 a skill$ nurs+ facility or a cl9ic    
7includ+ a rural heal? cl9ic7 t is      
op]at$ by a t]ritorial safety net       
hospital1 at ! "t ! specim5 is collect$4
  7#e7 ,cov]age ( co/s = c]ta9 on-call  
em]g5cy room provid]s ,9 det]m9+ !      
reasonable co/s ( outpati5t t]ritorial  

safety net hospital s]vices "u p>agraphs
 7#a7 & 7#b77;,a71 ! ,secret>y %all     
recognize z all[able co/s1 am\nts 7z    
def9$ by ! ,secret>y7 = reasonable      
comp5sation & relat$ co/s = physicians1 
physician assi/ants1 nurse practition]s1
 & cl9ical nurse speciali/s :o are      
on-call 7z def9$ by ! ,secret>y7 to     
provide em]g5cy s]vices b :o are n      
pres5t on ! premises ( ! t]ritorial     
safety net hospital involv$1 & are n    
o!rwise furni%+ s]vices cov]$ "u ?is    
title & are n on-call at any o!r provid]
 or facility4  4  7#b7 ,scope ( b5efits 
,section #ahcb7;a77#b7 ( ! ,social      
,security ,act 7#db ,u4,s4,c4           
#aciek7a77#b77 is am5d$-- 7,a7 9        
subp>agraph 7,i71 by /rik+ 2 & & ins]t+ 
a semicolon2  7,b7 9 subp>agraph 7,j71  
by /rik+ ! p]iod at ! end & ins]t+ 2 &2 
&  7,c7 by add+ at ! end ! foll[+ new   
subp>agraph3  7,k7 outpati5t t]ritorial 
safety net hospital s]vices 7z def9$ 9  
section #ahfa7nnn77#c774  4  7#c7       
,paym5t ( b5efits ,section #ahcc ( !    

,social ,security ,act 7#db ,u4,s4,c4   
#aciel7 is am5d$-- 7,a7 9 subsection    
7a7-- 7i7 9 p>agraph 7#i71 by /rik+ 2 & 
& ins]t+ a semicolon2  7ii7 9 p>agraph  
7#aj71 by /rik+ ! p]iod at ! end &      
ins]t+ 2 &2 &  7iii7 by ins]t+ aft]     
p>agraph 7#aj7 ! foll[+ new p>agraph3   
7#aa7 9 ! case ( outpati5t t]ritorial   
safety net hospital s]vices1 ! am\nts   
describ$ 9 section #ahcd7;aa74  2  7,b7 
9 subsection 7h77#e77;,a77iii71 by      
ins]t+ t]ritorial safety net hospital1  
aft] critical access hospital12  7,c7 9 
subsection 7i77#a77;,a71 by ins]t+      
t]ritorial safety net hospital1 aft]    
critical access hospital12  7,d7 9      
subsection 7l77#e7-- 7i7 9 subp>agraph  
7,a71 by ins]t+ t]ritorial safety net   
hospital1 aft] critical access hospital1
 9 ea* place x appe>s2 &  7ii7 9        
subp>agraph 7,b71 by /rik+ or critical  
access hospital 9 ea* place x appe>s &  
ins]t+ 1 critical access hospital1 or   
t]ritorial safety net hospital 9 ea* su*
 place2  7,e7 9 subsection 7r7-- 7i7 9  

p>agraph 7#a71 by ins]t+ t]ritorial     
safety net hospital1 aft] critical      
access hospital2 &  7ii7 9 p>agraph     
7#b71 by /rik+ or critical access       
hospital & ins]t+ 1 critical access     
hospital1 or t]ritorial safety net      
hospital2 &  7,f7 9 subsection 7cc77#b71
 by add+ at ! end ! foll[+ new          
subp>agraph3  7,f7 ,section #ahcd7;aa71 
) respect to an outpati5t t]ritorial    
safety net hospital s]vice4  4  7#d7    
,paym5t = ambulance s]vices furni%$ by a
 t]ritorial safety net hospital ,section
 #ahcd7l77#h7 ( ! ,social ,security ,act
 7#db ,u4,s4,c4 #aciem7l77#h77 is       
am5d$-- 7,a7 9 ! head+1 by ins]t+ &     
t]ritorial safety net hospitals aft]    
critical access hospitals2  7,b7 9      
subp>agraph 7,a71 by ins]t+ or a        
t]ritorial safety net hospital 7z def9$ 
9 section #ahfa7nnn77 aft] 7z def9$ 9   
section #ahfa7mm77#a772  7,c7 9         
subp>agraph 7,b71 by ins]t+ or a        
t]ritorial safety net hospital aft]     
critical access hospital2 &  7,d7 by    

am5d+ ! flu% left text foll[+           
subp>agraph 7,b7 to read z foll[s3 b    
only if ! critical access hospital1     
t]ritorial safety net hospital1 or      
entity is ! only provid] or suppli] (   
ambulance s]vices t is locat$ )9 a      
#ce-mile drive ( su* critical access    
hospital or t]ritorial safety net       
hospital4 4  7d7 ,con=m+ am5dm5ts  7#a7 
,title ,,xi  7,a7 ,civil monet>y        
p5alties ,section #aabh;,a7b77#a7 ( !   
,social ,security ,act 7#db ,u4,s4,c4   
#acbj;a-#g;a7b77#a77 is am5d$ by /rik+  
or a critical access hospital 9 ea*     
place x appe>s & ins]t+ 1 critical      
access hospital1 or t]ritorial safety   
net hospital 9 ea* su* place4  7,b7     
,crim9al p5alties = acts involv+ ,f$]al 
heal? c>e programs ,section #aabh;,b7c7 
( ! ,social ,security ,act 7#db         
,u4,s4,c4 #acbj;a-#g;b7c77 is am5d$ by  
ins]t+ t]ritorial safety net hospital1  
aft] critical access hospital14  7,c7   
,nonpr(it hospital philan?ropy ,section 
#aacd ( ! ,social ,security ,act 7#db   

,u4,s4,c4 #acbj;b-#d7 is am5d$ 9 ! matt]
 prec$+ p>agraph 7#a7 by /rik+ or       
critical access hospitals 9 ea* place x 
appe>s & ins]t+ 1 critical access       
hospitals1 or t]ritorial safety net     
hospitals 9 ea* su* place4  7,d7        
,hospital protocols = organ procurem5t &
 /&>ds = organ procurem5t ag5cies       
,section #aach ( ! ,social ,security    
,act 7#db ,u4,s4,c4 #acbj;b-#h7 is am5d$
 by /rik+ or critical access hospital 9 
ea* place x appe>s & ins]t+ 1 critical  
access hospital1 or t]ritorial safety   
net hospital 9 ea* su* place4  7#b7     
,title ,,xviii  7,a7 ,def9ition ( a     
hospital ,section #ahfa7;e7 ( ! ,social 
,security ,act 7#db ,u4,s4,c4 #aciex7e77
 is am5d$ 9 ! flu% left matt] at ! end  
by /rik+ or a rural em]g5cy hospital 7z 
def9$ 9 subsection 7kkk77#b77 & ins]t+ 1
 a rural em]g5cy hospital 7z def9$ 9    
subsection 7kkk77#b771 or a t]ritorial  
safety net hospital 7z def9$ 9          
subsection 7nnn77#a774  7,b7 ,def9ition 
( provid] ( s]vices ,section #ahfa7u7 ( 

! ,social ,security ,act 7#db ,u4,s4,c4 
#aciex7u77 is am5d$ by ins]t+ t]ritorial
 safety net hospital1 aft] critical     
access hospital14  7,c7 ,def9ition (    
reasonable co/s ,section                
#ahfa7v77#a77,s77ii77,,iii7 ( ! ,social 
,security ,act 7#db ,u4,s4,c4           
#aciex7v77#a77,s77ii77,,iii77 is am5d$  
by /rik+ or a critical access hospital  
7z def9$ 9 section #ahfa7mm77#a77 &     
ins]t+ 1 a critical access hospital 7z  
def9$ 9 section #ahfa7mm77#a771 or a    
t]ritorial safety net hospital 7z def9$ 
9 subsection 7nnn7 ( su* section74  7,d7
 ,def9ition ( arrangem5ts ,section      
#ahfa7w7 ( ! ,social ,security ,act 7#db
 ,u4,s4,c4 #aciex7w77 is am5d$-- 7i7 9  
p>agraph 7#a71 by ins]t+ t]ritorial     
safety net hospital1 aft] critical      
access hospital12 &  7ii7 9 p>agraph    
7#b71 by /rik+ or critical access       
hospital 9 ea* place x appe>s & ins]t+ 1
 critical access hospital1 or t]ritorial
 safety net hospital 9 ea* su* place4   
7,e7 ,def9ition ( po/-in/itutional home 

heal? s]vices2 home heal? spell (       
illness ,section #ahfa7tt7 ( ! ,social  
,security ,act 7#db ,u4,s4,c4           
#aciex7tt77 is am5d$-- 7i7 9 p>agraph   
7#a77;,a71 by /rik+ or critical access  
hospital & ins]t+ 1 critical access     
hospital1 or t]ritorial safety net      
hospital2 &  7ii7 9 p>agraph 7#b77;,b71 
by /rik+ or critical access hospital &  
ins]t+ 1 critical access hospital1 or   
t]ritorial safety net hospital4  7,f7   
,exclusion f cov]age ,section           
#ahfb7;a77#ad7 ( ! ,social ,security    
,act 7#db ,u4,s4,c4 #aciey7a77#ad77 is  
am5d$ by /rik+ or critical access       
hospital 9 ea* place x appe>s & ins]t+ 1
 critical access hospital1 or t]ritorial
 safety net hospital 9 ea* su* place4   
7,g7 ,use ( ,/ate ag5cies to det]m9e    
compliance by provid]s ( s]vices )      
conditions ( p>ticipation ,section #ahfd
 ( ! ,social ,security ,act 7#db        
,u4,s4,c4 #acie;aa7 is am5d$-- 7i7 9    
subsection 7a71 by ins]t+ t]ritorial    
safety net hospital1 z def9$ 9 section  

#ahfa7nnn77#a71 aft] a critical access  
hospital1 z def9$ 9 section             
#ahfa7mm77#a712 &  7ii7 by add+ at ! end
 ! foll[+ new subp>agraph3  7f7 ,=      
purposes ( ?is section1 ! t]m ,/ate     
means ! #ej ,/ates & includes ! ,di/rict
 ( ,columbia1 ,pu]to ,rico1 ! ,virg9    
,isl&s1 ,guam1 ,am]ican ,samoa1 & !     
,nor!rn ,m>iana ,isl&s4  4  7,h7        
,agreem5ts ) provid]s ( s]vices ,section
 #ahff7;a7 ( ! ,social ,security ,act   
7#db ,u4,s4,c4 #acie;cc7a77 is am5d$--  
7i7 9 p>agraph 7#a7-- 7,i7 9 subp>agraph
 7,f77ii71 by ins]t+ t]ritorial safety  
net hospitals1 aft] critical access     
hospitals12  7,,ii7 9 subp>agraph 7,h71 
by /rik+ & 9 ! case ( critical access   
hospitals :i* provide critical access   
hospital s]vices & ins]t+ 1 9 ! case (  
critical access hospitals :i* provide   
critical access hospital s]vices1 & 9 ! 
case ( t]ritorial safety net hospitals  
:i* provide t]ritorial safety net       
hospital s]vices2  7,,iii7 9 subp>agraph
 7,i71 by ins]t+ t]ritorial safety net  

hospital1 aft] critical access hospital1
 9 ea* place x appe>s2  7,,iv7 9        
subp>agraph 7,n71 by ins]t+ t]ritorial  
safety net hospital1 aft] critical      
access hospital1 9 ea* place x appe>s2  
7,v7 9 subp>agraph 7,t71 by /rik+ &     
critical access hospitals & ins]t+ 1    
critical access hospitals1 & t]ritorial 
safety net hospitals2 &  7,,vi7 9       
subp>agraph 7,y71 by /rik+ or critical  
access hospital ea* place x appe>s &    
ins]t+ 1 critical access hospital1 or   
t]ritorial safety net hospital 9 ea* su*
 place2 &  7ii7 9 p>agraph 7#c7-- 7,i7 9
 subp>agraph 7,a71 by ins]t+ t]ritorial 
safety net hospital1 aft] critical      
access hospital12  7,,ii7 9 subp>agraph 
7,b71 by ins]t+ t]ritorial safety net   
hospital1 aft] critical access hospital1
 9 ea* place x appe>s2 &  7,,iii7 9     
subp>agraph 7,c77ii77,,ii71 by ins]t+   
t]ritorial safety net hospitals1 aft]   
critical access hospitals1 9 ea* place x
 appe>s4  7,i7 ,exam9ation & treatm5t = 
em]g5cy m$ical conditions & wom5 9 labor

 ,section #ahfg7;e77#e7 ( ! ,social     
,security ,act 7#db ,u4,s4,c4           
#acie;dd7e77#e77 is am5d$ by ins]t+ 1   
t]ritorial safety net hospital 7z def9$ 
9 section #ahfa7nnn77#a771 aft] 7z def9$
 9 section #ahfa7mm77#a774  7,j7        
,hospital provid]s ( ext5d$ c>e s]vices 
,section #ahhc7;a77#c7 ( ! ,social      
,security ,act 7#db ,u4,s4,c4           
#aciett7a77#c77 is am5d$ by ins]t+ or a 
t]ritorial safety net hospital aft]     
critical access hospital4  7,k7 ,paym5t 
to skill$ nurs+ facilities = r\t9e c>e  
,section #ahhh7;e77#f77;,b7 ( ! ,social 
,security ,act 7#db ,u4,s4,c4           
#acieyy7e77#f77;,b77 is am5d$-- 7i7 9   
clause 7i71 by ins]t+ or a t]ritorial   
safety net hospital aft] critical access
 hospital2 &  7ii7 9 clause 7ii71 by    
ins]t+ or a t]ritorial safety net       
hospital aft] critical access hospital4 
7,l7 ,/&>diz$ po/-acute c>e 7,,pac7     
assessm5t data = quality1 paym5t1 &     
dis*>ge plann+ ,section #ahii;,b ( !    
,social ,security ,act 7#db ,u4,s4,c4   

#acielll7 is am5d$-- 7i7 9 subsection   
7c77#a77;,e7-- 7,i7 9 clause 7i71 by    
/rik+ or critical access hospital &     
ins]t+ 1 critical access hospital1 or   
t]ritorial safety net hospital2 &       
7,,ii7 9 clause 7ii71 by ins]t+         
t]ritorial safety net hospital1 aft]    
critical access hospital12 &  7ii7 9    
subsection 7i77#a7-- 7,i7 9 ! fir/      
s5t5ce1 by /rik+ & critical access      
hospitals & ins]t+ 1 critical access    
hospitals1 & t]ritorial safety net      
hospitals2 &  7,,ii7 9 ! ?ird s5t5ce1 by
 ins]t+ t]ritorial safety net hospitals1
 aft] critical access hospitals14  #c4  
,inclusion ( t]ritorial safety net      
hospitals z #cdj;,b cov]$ entities      
,section #cdj;,b7a77#d7 ( ! ,public     
,heal? ,s]vice ,act 7#db ,u4,s4,c4      
#bef;b7a77#d77 is am5d$ by add+ at ! end
 ! foll[+ new subp>agraph3  7,p7 ,an    
entity t is a t]ritorial safety net     
hospital 7z def9$ 9 section #ahfa7nnn7 (
 ! ,social ,security ,act71 & t meets ! 
requirem5ts ( subp>agraph 7,l77i74  4   

#d4 ,elim9at+ m$ic>e seque/ration =     
t]ritorial safety net hospitals  7a7    
,elim9at+ ,m$ic>e seque/ration =        
t]ritorial safety net hospitals  7#a7 ,9
 g5]al ,section #bef7;d77#g7 ( !        
,balanc$ ,budget & ,em]g5cy ,deficit    
,control ,act ( #aihe 7#b ,u4,s4,c4     
#ijf7;d77#g77 is am5d$ by add+ at ! end 
! foll[+3  7,d7 ,t]ritorial safety net  
hospitals ,paym5ts "u "p ,a or "p ,b (  
title ,,xviii ( ! ,social ,security ,act
 ) respect to items & s]vices furni%$ by
 a t]ritorial safety net hospital 7z    
def9$ 9 section #ahfa7nnn77#a7 ( su*    
,act74  4  7#b7 ,applicability ,!       
am5dm5t made by ?is section applies )   
respect to ord]s ( seque/ration         
effective on or aft] ! date t is #fj    
days aft] ! date ( ! enactm5t ( ?is     
,act4  7b7 ,rev]s+ cuts to reimbursem5t 
( bad debt = t]ritorial safety net      
hospitals  7#a7 ,t]ritorial safety net  
hospitals ,section #ahfa7v77#a77,w77ii7 
( ! ,social ,security ,act 7#db         
,u4,s4,c4 #aciex7v77#a77,w77ii77 is     

am5d$ by ins]t+ aft] or 7,v7 ! foll[+3 1
 a t]ritorial safety net hospital4  7#b7
 ,applicability ,! am5dm5ts made by ?is 
section apply ) respect to co/ report+  
p]iods beg9n+ m ?an #fj days aft] ! date
 ( ! enactm5t ( ?is ,act4