,i  #aai? ,,congress  #b;d ,session  ,h4
 ,r4 #ajgbh  ,,9 ,,! ,,h\se ,,(         
,,repres5tatives  ,octob] #e1 #bjbf,ms4 
,davids ( ,kansas introduc$ ! foll[+    
bill2 :i* 0 ref]r$ to ! ,committee on   
,en]gy & ,comm]ce  ,a ,,bill  ,to       
provide t c]ta9 limits on ,/ate-direct$ 
paym5ts "u ! ,m$icaid program n apply to
 c]ta9 mat]nity1 labor1 & deliv]y       
s]vices4  #a4 ,%ort title ,?is ,act may 
be cit$ z ! ,mat]nity ,c>e = ,rural     
,communities ,act ( #bjbf4  #b4 ,provid+
 t c]ta9 limits on ,/ate-direct$ paym5ts
 "u ! ,m$icaid program n apply to c]ta9 
mat]nity1 labor1 & deliv]y s]vices      
,section #gaaaf7;b7 ( an ,act to provide
 = reconciliation pursuant to title ,,ii
 ( ,h4 ,con4 ,res4 #ad 7,public ,law    
#aai-ba7 is am5d$--  7#a7 9 ! head]1 by 
/rik+ ,gr&fa!r+ & ins]t+ ,treatm5t (2   
7#b7 by /rik+ ,9 ! case ( & ins]t+ !    
foll[+3  7#a7 ,gr&fa!r+ ,9 ! case (  2 &
  7#c7 by add+ at ! end ! foll[+ new    
p>agraph3  7#b7  ,exemption = paym5ts = 
c]ta9 mat]nity1 labor1 & deliv]y s]vices

  ,9 ! case ( a paym5t describ$ 9       
section #dch4f7;c77#b77;iii7 ( title    
#db1 ,code ( ,f$]al ,regulations 7or a  
successor regulation71 made = mat]nity1 
labor1 or deliv]y s]vices furni%$ dur+ a
 rat+ p]iod beg9n+ on or aft] ,july #d1 
#bjbe1 by a specifi$ entity1 no limit on
 su* paym5t %all apply4  7#c7           
,def9itions ,9 ?is subsection3 7,a7     
,qualify+ bir?s ,! t]m qualify+ bir?    
means1 ) respect to a bir? at a         
hospital1 any bir? ) respect to :i* !   
individual giv+ bir?--  7i7 receiv$     
mat]nity1 labor1 or deliv]y s]vices =   
:i* paym5t = su* s]vices 0 made 9 :ole  
or 9 "p "u-- 7,i7 a ,/ate plan "u title 
,,xix ( ! ,social ,security ,act 7or    
waiv] ( su* plan72  7,,ii7 a ,/ate *ild 
heal? plan "u title ,,xxi ( su* ,act 7or
 a waiv] ( su* plan72 or  7,,iii7 title 
,,xviii ( su* ,act2  7ii7 receiv$       
mat]nity1 labor1 or deliv]y s]vices     
provid$ by ! ,indian ,heal? ,s]vice or a
 ,native ,hawaiian heal? c>e sy/em 7z   
def9$ 9 section #ab ( ! ,native         

,hawaiian ,heal? ,c>e ,improvem5t ,act72
 or  7iii7 did n h m9imum ess5tial      
cov]age 7z def9$ 9 section #ejjj;,a7f7 (
 ! ,int]nal ,rev5ue ,code ( #aihf7 & =  
:i* ! hospital incurr$ uncomp5sat$ c>e  
co/s 7o!r ?an *>ity c>e co/s74  7,b7    
,specifi$ entity ,! t]m specifi$ entity 
means any ( ! foll[+ entities3 7i7 ,a   
rural hospital4  7ii7 ,a hospital op]at$
 by ! ,indian ,heal? ,s]vice or by an   
,indian ,tribe "u ! ,indian             
,self-,det]m9ation & ,education         
,assi/ance ,act4  7iii7 ,a hospital =   
:i*1 ) respect to ! mo/ rec5t #ab-mon?  
p]iod = :i* data is available1 at lea/  
#ej p]c5t ( all bir?s at su* hospital 7 
qualify+ bir?s4  4