,i  #aai? ,,congress  #a/ ,session  ,h4 
,r4 #agge  ,,9 ,,! ,,h\se ,,(           
,,repres5tatives  ,m>* #c1 #bjbe,mr4    
,arr+ton 7= himself1 ,ms4 ,tokuda1 &    
,mr4 ,pflug]7 introduc$ ! foll[+ bill2  
:i* 0 ref]r$ to ! ,committee on ,ways & 
,means1 & 9 addition to ! ,committee on 
,en]gy & ,comm]ce1 = 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   
modify ! crit]ia = designation ( rural  
em]g5cy hospitals4  #a4 ,%ort title ,?is
 ,act may be cit$ z ! ,second ,*ances = 
,rural ,hospitals ,act4  #b4 ,exp&+ !   
def9ition ( rural em]g5cy hospital "u ! 
,m$ic>e program  7a7 ,9 g5]al ,section  
#ahfa7kkk7 ( ! ,social ,security ,act   
7#db ,u4,s4,c4 #aciex7kkk77 is am5d$--  
7#a7 9 p>agraph 7#b77;,a71 by /rik+ is  
enroll$ "u section #ahff7;j7 & ins]t+   
except 9 ! case ( a facility describ$ 9 
p>agraph 7#c77;,b72  7#b7 9 p>agraph    

7#c7-- 7,a7 9 subp>agraph 7,b71 by /rik+
 ! p]iod at ! end & ins]t+ 2 or2  7,b7  
by r$esignat+ subp>agraphs 7,a7 & 7,b7 z
 clauses 7i7 & 7ii71 respectively1 &    
adju/+ ! m>g9s accord+ly2  7,c7 by /rik+
 facility t z ( & ins]t+ facility-- 7,a7
 t z (  2 &  7,d7 by add+ at ! end !    
foll[+ new subp>agraph3  7,b7 t-- 7i7   
dur+ ! p]iod beg9n+ ,janu>y #a1 #bjad1 &
 end+ ,decemb] #bf1 #bjbj-- 7,i7 0 a    
critical access hospital2 or  7,,ii7 0 a
 subsection 7d7 hospital 7z def9$ 9     
section #ahhf7;d77#a77;,b77 locat$ 9 a  
c\nty 7or equival5t unit ( local        
gov]nm5t7 9 a rural area 7z def9$ 9     
section #ahhf7;d77#b77;,d772 &  7ii7 z (
 ! date ( ! enactm5t ( ?is subp>agraph1 
_h ceas$ op]ations4  2 &  7#c7 9        
p>agraph 7#d7-- 7,a7 9 subp>agraph      
7,a77i71 by /rik+ ,an action plan &     
ins]t+ ,except 9 ! case ( a facility    
describ$ 9 p>agraph 7#c77;,b71 an action
 plan2 &  7,b7 9 subp>agraph 7,b77i71 by
 ins]t+ except 9 ! case ( a facility    
describ$ 9 p>agraph 7#c77;,b71 be=e !   

facility4  7b7 ,am5dm5ts to paym5t rules
 ,section #ahcd7x7 ( ! ,social ,security
 ,act 7#db ,u4,s4,c4 #aciem7x77 is      
am5d$-- 7#a7 9 p>agraph 7#a71 by ins]t+ 
1 except t1 9 ! case ( a facility       
describ$ 9 section #ahfa7kkk77#c77;,b7  
t1 z ( ! date on :i* su* facility       
submits an application "u section       
#ahff7;j7 to enroll "u ?is title z a    
rural em]g5cy hospital1 is locat$ less  
?an #ce miles away f ! ne>e/ hospital1  
critical access hospital1 or rural      
em]g5cy hospital1 su* increase %all n   
apply be=e ! p]iod at ! end2 &  7#b7 9  
p>agraph 7#b77;,a71 by ins]t+ 7o!r ?an a
 facility describ$ 9 section            
#ahfa7kkk77#c77;,b7 t1 z ( ! date on :i*
 su* facility submits an application "u 
section #ahff7;j7 to enroll "u ?is title
 z a rural em]g5cy hospital1 is locat$  
less ?an #aj miles away f ! ne>e/       
hospital1 critical access hospital1 or  
rural em]g5cy hospital7 aft] rural      
em]g5cy hospital4  7c7 ,effective date  
,! am5dm5ts made by ?is section %all    

apply beg9n+ ,janu>y #a1 #bjbg4