,i  #aai? ,,congress  #b;d ,session  ,h4
 ,r4 #gdji  ,,9 ,,! ,,h\se ,,(          
,,repres5tatives  ,febru>y #e1 #bjbf,mr4
 ,taylor 7= himself & ,mrs4 ,mill] (    
,we/ ,virg9ia7 introduc$ ! foll[+ bill2 
:i* 0 ref]r$ to ! ,committee on ,ways & 
,means  ,a ,,bill  ,to am5d title       
,,xviii ( ! ,social ,security ,act to   
limit ! geographic reclassification (   
c]ta9 hospitals "u ! ,m$ic>e program4   
#a4 ,%ort title ,?is ,act may be cit$ z 
! ,def5d ,rural ,heal? ,act ( #bjbf4    
#b4 ,limit+ geographic reclassification 
( hospitals "u ,m$ic>e  7a7 ,9 g5]al    
,section #ahhf7;d77#h77;,e7 ( ! ,social 
,security ,act 7#db ,u4,s4,c4           
#acieww7d77#h77;,e77 is am5d$-- 7#a7 9  
clause 7i71 by /rik+ describ$ 9 clause  
7ii7 & ins]t+ t is locat$ 9 an urban    
area 7z def9$ 9 p>agraph 7#b77;,d77 &   
meets any ( ! crit]ia describ$ 9        
subclause 7,i71 7,,ii71 or 7,,iv7 (     
clause 7ii7 7or1 ) respect to a hospital
 submitt+ su* an application be=e       
,octob] #a1 #bjbf1 meets any ( ! crit]ia

 describ$ 9 su* clause72  7#b7 9 clause 
7ii7-- 7,a7 9 ! matt] prec$+ subclause  
7,i71 by /rik+ a subsection 7d7 hospital
 & all t foll[s ?r\gh crit]ia3 & ins]t+ 
! crit]ia describ$ 9 ?is clause are !   
foll[+32 &  7,b7 9 subclause 7,,ii7--   
7i7 by ins]t+ t is be=e designat$ by any
 law2 &  7ii7 by ins]t+ 1 & t 0 s       
designat$ z ( ,janu>y #a1 #bjbf be=e !  
p]iod at ! end2 &  7#c7 by add+ at ! end
 ! foll[+ new clause3  7iii7 ,no        
subsection 7d7 hospital %all be treat$ z
 be+ locat$ 9 a rural area ( a ,/ate "u 
?is subp>agraph on or aft] ,octob] #a1  
#bjbi1 reg>dless ( any application      
describ$ 9 clause 7i7 submitt$ prior to 
,octob] #a1 #bjbf1 unless su* hospital  
demon/rates to ! ,secret>y 79 a =m &    
mann] specifi$ by ! ,secret>y7 t su*    
hospital meets any ( ! crit]ia describ$ 
9 subclause 7,i71 7,,ii71 or 7,,iv7 (   
clause 7ii74  4  7b7 ,prohibit+ dual    
reclassifications ?r\gh ! ,m$ic>e       
,geographic ,classification ,review     
,bo>d ,section #ahhf7;d77#aj77;,d7 ( !  

,social ,security ,act 7#db ,u4,s4,c4   
#acieww7d77#aj77;,d77 is am5d$-- 7#a7 9 
clause 7v71 by /rik+ ,any decision &    
ins]t+ ,subject to clause 7viii71 any   
decision2 &  7#b7 by add+ at ! end !    
foll[+ new clauses3  7vii7 ,su*         
guidel9es %all provide t ! ,bo>d may n  
approve an application describ$ 9       
subp>agraph 7,c77i7 submitt$ by a       
subsection 7d7 hospital reque/+ a *ange 
9 geographic classification = a fiscal  
ye> beg9n+ on or aft] ,octob] #a1 #bjbf1
 if su* hospital is treat$ z be+ locat$ 
9 a rural area "u p>agraph 7#h77;,e7 =  
su* fiscal ye>4  7viii7 ,) respect to a 
fiscal ye> beg9n+ on or aft] ,octob] #a1
 #bjbf1 no *ange 9 ! geographic         
classification ( a subsection 7d7       
hospital t w\ld o!rwise be 9 effect =   
su* fiscal ye> pursuant to a decision ( 
! ,bo>d %all be effective = any portion 
( su* fiscal ye> dur+ :i* su* hospital  
is treat$ z be+ locat$ 9 a rural area "u
 p>agraph 7#h77;,e74  4