,i  #aai? ,,congress  #b;d ,session  ,h4
 ,r4 #hihf  ,,9 ,,! ,,h\se ,,(          
,,repres5tatives  ,may #ba1 #bjbf,mr4   
,ne:\se 7= himself & ,mr4 ,l>s5 (       
,wa%+ton7 introduc$ ! foll[+ bill2 :i* 0
 ref]r$ to ! ,committee on ,ways &      
,means  ,a ,,bill  ,to am5d title       
,,xviii ( ! ,social ,security ,act to   
all[ = ! designation ( c]ta9 facilities 
z critical access hospitals "u ! ,m$ic>e
 program4  #a4 ,%ort title ,?is ,act may
 be cit$ z ! ,ensur+ ,rural ,heal? ,c>e 
,access = ,milit>y & ,tribal ,families  
,act4  #b4 ,provid+ ess5tial heal? c>e  
access = memb]s ( ! ,arm$ ,=ces1        
dep5d5ts1 & vet]ans 9 rural areas       
,section #ahbj7;c77#b7 ( ! ,social      
,security ,act 7#db ,u4,s4,c4           
#acie;i-#d7;c77#b77 is am5d$--  7#a7 9  
subp>agraph 7,b77i71 by ins]t+ subject  
to subp>agraph 7,f71 be=e is a hospital2
  7#b7 9 subp>agraph 7,e77ii71 by /rik+ 
,! total & ins]t+ ,subject to           
subp>agraph 7,f71 ! total2 &  7#c7 by   
add+ at ! end ! foll[+ new subp>agraph3 

7,f7 ,ess5tial heal? c>e access = memb]s
 ( ! ,arm$ ,=ces1 dep5d5ts1 & vet]ans 9 
rural areas  7i7 ,9 g5]al ,beg9n+       
,octob] #a1 #bjbf1 a ,/ate may designate
 a facility z a critical access hospital
 )\t reg>d to ! crit]ia "u subp>agraph  
7,b77i7 if ! facility meets #c or m ( ! 
foll[+ crit]ia3  7,i7 ,! hospital-- 7aa7
 deliv]s heal? c>e s]vices to           
individuals cov]$ "u ! ,,tric>e program 
7z def9$ 9 section #ajgb ( title #aj1   
,unit$ ,/ates ,code7 & vet]ans enroll$ 9
 ! pati5t enrollm5t sy/em "u section    
#agje ( title #ch1 ,unit$ ,/ates ,code1 
liv+ 9 rural areas2 &  7bb7 is locat$ 9 
a c\nty 7or equival5t unit ( local      
gov]nm5t7 9 a rural area 7z def9$ 9     
section #ahhf7;d77#b77;,d77 or is treat$
 z be+ locat$ 9 a rural area pursuant to
 section #ahhf7;d77#h77;,e71 or is      
locat$ 9 an area t o!rwise meets !      
def9ition ( rural e/abli%$ by ! ,f$]al  
,(fice ( ,rural ,heal? ,policy4  7,,ii7 
,! hospital is n a sole community       
hospital 7z def9$ 9 section             

#ahhf7;d77#e77;,d77iii774  7,,iii7 ,at !
 "t ( designation1 #h p]c5t or m ( !    
annual gross rev5ue ( ! hospital & its  
provid]-bas$ dep>tm5ts1 includ+         
affiliat$ outpati5t dep>tm5t &          
provid]-bas$ cl9ics1 is d]iv$ f s]vices 
provid$ to individuals cov]$ "u !       
,,tric>e program4  7,,iv7 ,at ! "t (    
designation1 #ae p]c5t or m ( ! annual  
gross rev5ue f labor & deliv]y s]vices (
 ! hospital is d]iv$ f s]vices provid$  
to individuals cov]$ "u ! ,,tric>e      
program4  7,v7 ,! hospital is locat$ on 
a res]vation 7z def9$ 9 section #d ( !  
,indian ,heal? ,c>e ,improvem5t ,act74  
7ii7 ,psy*iatric & rehabilitation di/9ct
 "p units ,a facility describ$ 9 clause 
7i7 may e/abli% a di/9ct "p unit "u     
subp>agraph 7,e7 )\t reg>d to !         
limitation on numb] ( b$s "u clause 7ii7
 ( su* subp>agraph4 ,! ,secret>y may n  
take a di/9ct "p unit s e/abli%$ by su* 
facility into acc\nt :5 det]m9+ :e!r su*
 facility is prim>ily engag$ 9 provid+ !
 s]vices describ$ 9 section             

#ahfa7;e77#a74  4