,,ii  #aaith ,,congress  #ast ,session  
,s4 #acij  ,,in ,,the ,,senate ,,of     
,,the ,,united ,,states  ,april #i1     
#bjbe,mr4 ,lankford 7for himself1 ,mr4  
,marshall1 ,mr4 ,cassidy1 ,mr4 ,tillis1 
,mr4 ,cornyn1 ,mr4 ,mullin1 ,mr4        
,boozman1 ,mr4 ,barrasso1 and ,mr4      
,budd7 introduced the following bill2   
which was read twice and referred to the
 ,committee on ,finance  ,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  7,a7 ,in  
general ,the term covered rural hospital
 means a hospital that-- 7i7 is located 
in a rural area 7as defined in section  
#ahhf7;d77#b77;,d772 and  7ii7 as of the
 date that such hospital enrolls under  
this title1 meets the criteria described
 in clause 7i77,i7 of section           
#ahbj7;c77#b77;,b74  7,b7 ,clarification
 ,nothing in this paragraph shall be    
interpreted as requiring a covered rural
 hospital to meet any other criteria    
under section #ahbj7;c77#b77;,b74  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