,i  #aaith ,,congress  #ast ,session    
,h4 ,r4 #baia  ,,in ,,the ,,house ,,of  
,,representatives  ,march #ah1 #bjbe,mr4
 ,griffith 7for himself1 ,mr4 ,hern of  
,oklahoma1 ,mr4 ,vicente ,gonzalez of   
,texas1 ,mr4 ,joyce of ,pennsylvania1   
,mr4 ,correa1 ,mr4 ,balderson1 ,mr4     
,valadao1 ,mr4 ,pfluger1 ,mr4 ,dunn of  
,florida1 ,mr4 ,davis of ,north         
,carolina1 ,mr4 ,yakym1 ,mr4 ,weber of  
,texas1 ,mrs4 ,miller-,meeks1 and ,mr4  
,austin ,scott of ,georgia7 introduced  
the following bill2 which was referred  
to the ,committee on ,energy and        
,commerce1 and in addition to the       
,committee on ,ways and ,means1 for a   
period to be subsequently determined by 
the ,speaker1 in each case for          
consideration of such provisions as fall
 within the jurisdiction of the         
committee concerned  ,a ,,bill  ,to     
amend title ,,xviii of the ,social      
,security ,act to revise certain        
physician self-referral exemptions      
relating to physician-owned hospitals4  

#a4 ,short title ,this ,act may be cited
 as the ,physician ,led and ,rural      
,access to ,quality ,care ,act4  #b4    
,revising certain physician             
self-referral exemptions relating to    
physician-owned hospitals  7a7 ,in      
general ,section #ahgg of the ,social   
,security ,act 7#db ,u4,s4,c4 #acienn7  
is amended--  7#a7 in subsection 7d7--  
7,a7 in paragraph 7#b77;,c71 by         
inserting 7other than a covered rural   
hospital 7as defined in subsection 7h777
 after a hospital2 and  7,b7 in         
paragraph 7#c77;,d71 by inserting in the
 case of a hospital other than a covered
 rural hospital 7as defined in          
subsection 7h771 before the hospital2   
and  7#b7 in subsection 7h71 by adding  
at the end the following new paragraph3 
7#h7 ,covered rural hospital ,the term  
covered rural hospital means a hospital 
that-- 7,a7 is located in a rural area  
7as defined in section                  
#ahhf7;d77#b77;,d772 and  7,b7 as of the
 date that such hospital enrolls under  

this title1 is located more than a      
#ce-mile drive 7or1 in the case of      
mountainous terrain or in areas with    
only secondary roads available1 a       
#ae-mile drive7 from a hospital or a    
critical access hospital4  4  7b7       
,allowing for expansion of existing     
physician-,owned hospitals ,section     
#ahgg7;i7 of the ,social ,security ,act 
7#db ,u4,s4,c4 #acienn7i77 is amended-- 
7#a7 in paragraph 7#a77;,b71 by striking
 in paragraph 7#c7 and inserting in     
paragraph 7#c7 or 7#g72 and  7#b7 by    
adding at the end the following new     
paragraph3  7#g7 ,sunset of expansion   
prohibition ,the requirement described  
in paragraph 7#a77;,b7 shall not apply  
beginning on the date of the enactment  
of this paragraph4  4