,i  #aai? ,,congress  #b;d ,session  ,h4
 ,r4 #hjeg  ,,9 ,,! ,,h\se ,,(          
,,repres5tatives  ,m>* #bd1 #bjbf,mrs4  
,mill]-,meeks 7= h]self & ,mr4          
,mc,cormick7 introduc$ ! foll[+ bill2   
:i* 0 ref]r$ to ! ,committee on         
,vet]ans' ,affairs  ,a ,,bill  ,to am5d 
title #ch1 ,unit$ ,/ates ,code1 to      
modify ! rate ( pay = c>e or s]vices    
provid$ "u ! ,community ,c>e ,program ( 
! ,dep>tm5t ( ,vet]ans ,affairs bas$ on 
! location at :i* su* c>e or s]vices 7  
provid$1 & = o!r purposes4  #a4 ,rates (
 pay = a provid] ( c>e or s]vices       
furni%$ to a vet]an "u ! ,community ,c>e
 ,program ( ! ,dep>tm5t ( ,vet]ans      
,affairs  7a7 ,rates ,section           
#agjc7;i77#a7 ( title #ch1 ,unit$ ,/ates
 ,code1 is am5d$-- 7#a7 by /rik+ ,except
 z provid$ 9 p>agraph 7#b71 & ins]t+    
7,a7 ,except z provid$ 9 p>agraph 7#b712
 &  7#b7 by add+ at ! end ! foll[+ new  
subp>agraphs3  7,b7 ,n lat] ?an ,janu>y 
#a1 #bjbg1 ! ,secret>y %all e/abli%     
rates = paym5ts to provid]s ( c>e or    

s]vices "u subp>agraph 7,a7 t are       
specific ) respect to ! foll[+ sites (  
s]vice at :i* ! c>e or s]vice is        
actually provid$ 7reg>dless ( ! physical
 location ( ! headqu>t]s ( ! provid]73  
7i7 ,a hospital outpati5t dep>tm5t4     
7ii7 ,an ambulatory surgical c5t]4      
7iii7 ,! (fice ( a physician4  7iv7 ,su*
 o!r sites z ! ,secret>y det]m9es       
appropriate 9 c>ry+ out ?is p>agraph4   
7,c7 ,! ,secret>y %all ensure t-- 7i7   
ea* site specifi$ 9 subp>agraph 7,b7    
obta9s a ,national ,provid] ,id5tifi] "u
 section #fbbe ( ! ,consolidat$         
,appropriations ,act1 #bjbf 7,public    
,law #aai-ge7 t is sep>ate & unique f   
su* id5tifi] = su* provid]2 &  7ii7 no  
paym5t = c>e or s]vices "u any provision
 9 ?is title may be made unless ! claim 
= su* paym5t includes ! ,national       
,provid] ,id5tifi] = ! site at :i* su*  
hospital c>e1 m$ical s]vices1 or ext5d$ 
c>e s]vices 7 furni%$4  7,d7 ,9 ! case (
 cov]$ ,,opd s]vices 7z def9$ 9 section 
#ahcc7t77#a77;,b7 ( ! ,social ,security 

,act 7#db ,u4,s4,c4 #aciel7t77#a77;,b77 
t are provid$ on or aft] ,janu>y #a1    
#bjbg1 by a provid] t is an (f-campus   
outpati5t dep>tm5t ( a provid] 7z def9$ 
9 section #ahcc7t77#ba77;,b7 ( ! ,social
 ,security ,act 7#db ,u4,s4,c4          
#aciel7t77#ba7;,b771 disreg>d+ clauses  
7ii7 & 7iv7 !re(1 z if su* clauses did n
 exi/71 ! ,secret>y %all ensure t su*   
dep>tm5t is treat$ z a subp>t ( su*     
provid] & assign$ a unique heal?        
id5tifi] pursuant to subp>agraph 7,c7 ( 
?is p>agraph1 & t su* provid] includes  
su* id5tifi] on any claim =m x submits  
"u ?is subsection1 & t su* provid] may n
 hold a vet]an liable = su* item or     
s]vice unless su* c>e or s]vices are    
bill$ us+ ! sep>ate unique heal?        
id5tifi] e/abli%$ = su* dep>tm5t "u ?is 
p>agraph4  7,e7 ,no?+ 9 ?is p>agraph may
 be con/ru$ to-- 7i7 prev5t ! ,secret>y 
f det]m9+ ! appropriate am\nt ( a       
facility fee2  7ii7 require ! ,secret>y 
to pay1 = ! same item or s]vice-- 7,i7  
an indep5d5t physician ! same am\nt z ! 

,secret>y w\ld pay a hospital-bas$      
physician2 or  7,,ii7 a hospital-bas$   
physician less ?an ! ,secret>y w\ld pay 
an indep5d5t physician2 or  7iii7 affect
 ! au?ority ( ! ,secret>y "u p>agraph   
7#b74  4  7b7 ,effective date ,!        
am5dm5ts made by subsection 7a7 %all    
take effect on ,janu>y #a ( ! fir/      
cal5d> ye> beg9n+ aft] ! date ( !       
enactm5t ( ?is ,act4