,i  #aai? ,,congress  #a/ ,session  ,h4 
,r4 #dbej  ,,9 ,,! ,,h\se ,,(           
,,repres5tatives  ,june #cj1 #bjbe,mr4  
,begi* 7= himself & ,ms4 ,tokuda7       
introduc$ ! foll[+ bill2 :i* 0 ref]r$ to
 ! ,committee on ,en]gy & ,comm]ce1 & 9 
addition to ! ,committee on ,ways &     
,means1 = 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     
floor on paym5ts to sole community      
hospitals locat$ 9 ,alaska & ,hawaii "u 
! hospital outpati5t prospective paym5t 
sy/em4  #a4 ,%ort title ,?is ,act may be
 cit$ z ! ,save our ,lone ,em]g5cy      
,s]vices ,act or ! ,,soles ,act4  #b4   
,treatm5t ( sole community hospitals    
locat$ 9 ,alaska & ,hawaii "u hospital  
outpati5t prospective paym5t sy/em      
,section #ahcc7t7 ( ! ,social ,security 
,act 7#db ,u4,s4,c4 #aciel7t77 is am5d$ 
by add+ at ! end ! foll[+ new p>agraph3 

7#bc7 ,treatm5t ( sole community        
hospitals locat$ 9 ,alaska & ,hawaii    
7,a7 ,9 g5]al ,if ! ,secret>y det]m9es t
 ! am\nt ( paym5t "u ?is subsection =   
cov]$ ,,opd s]vices furni%$ by a sole   
community hospital 7z def9$ 9 section   
#ahhf7;d77#e77;,d77iii77 t is locat$ 9  
,alaska or ,hawaii is less ?an #id p]c5t
 ( ! reasonable co/s 7z def9$ 9 section 
#ahfa7v77 ( ! hospital provid+ su*      
s]vices1 ! am\nt ( paym5t "u ?is        
subsection %all be increas$ by ! am\nt (
 su* diff]5ce4  7,b7 ,no effect on      
copaym5ts ,no?+ 9 ?is p>agraph %all be  
con/ru$ to affect ! copaym5t am\nt "u   
p>agraph 7#h74  7,c7 ,application )\t   
reg>d to budget neutrality ,! additional
 paym5ts made "u ?is p>agraph-- 7i7 %all
 n be consid]$ an adju/m5t "u p>agraph  
7#b77;,e72 &  7ii7 %all n be implem5t$ 9
 a budget neutral mann]4  7,d7 ,rulemak+
 ,n lat] ?an #f mon?s aft] ! date (     
enactm5t ( ?is p>agraph1 ! ,secret>y    
%all promulgate regulations to c>ry out 
?is p>agraph1 :i* %all be effective )   

respect to cov]$ ,,opd s]vices furni%$  
on or aft] ! fir/ ,janu>y #a aft] su*   
date4  4