#aaith ,,congress  #b;d ,session  ,s4   
#ddfj  ,,an ,,act  ,to provide for an   
extension of the rural community        
hospital demonstration program4  #a4    
,short title ,this ,act may be cited as 
the ,rural ,community ,hospital         
,demonstration ,program                 
,reauthorization4  #b4 ,five-year       
extension of the rural community        
hospital demonstration program  7a7 ,in 
general ,subsection 7a77#e7 of section  
#daj;,a of the ,medicare ,prescription  
,drug1 ,improvement1 and ,modernization 
,act of #bjjc 7,public ,law #ajh-agc2   
#db ,u4,s4,c4 #acieww note71 is amended 
by striking #ae-year extension period   
and inserting #bj-year extension period4
  7b7 ,conforming amendments for        
extension  7#a7 ,extension of           
demonstration period ,subsection 7g7 of 
such section #daj;,a is amended-- 7,a7  
in the subsection heading1 by striking  
,fifteen-,year and inserting            
,twenty-,year2  7,b7 in paragraph 7#a7--
 7i7 by striking additional #ae-year and

 inserting additional #bj-year2 and     
7ii7 by striking #ae-year extension     
period and inserting #bj-year extension 
period2  7,c7 in paragraph 7#b71 by     
striking #ae-year extension period and  
inserting #bj-year extension period2    
7,d7 in paragraph 7#c71 by striking     
#ae-year extension period and inserting 
#bj-year extension period2  7,e7 in     
paragraph 7#d71 by striking #ae-year    
extension period each place it appears  
and inserting #bj-year extension period2
  7,f7 in paragraph 7#e71 by striking   
#ae-year extension period each place it 
appears and inserting #bj-year extension
 period2 and  7,g7 in subparagraph 7,a7 
of paragraph 7#f71 by striking #ae-year 
extension period and inserting #bj-year 
extension period4  7#b7 ,rule for       
hospitals that are not original         
participants in the demonstration       
,paragraph 7#e7 of subsection 7g7 of    
such section #daj;,a is amended-- 7,a7  
in subparagraph 7,b71 by striking       
,additional extension and inserting     

,,caa1 #bjba extension2 and  7,b7 by    
adding at the end the following new     
subparagraph3  7,c7 ,additional         
extension ,during the fourth #e years of
 the #bj-year extension period1 the     
,secretary shall apply the provisions of
 paragraph 7#d7 to rural community      
hospitals that are not described in     
paragraph 7#d7 but are participating in 
the demonstration program under this    
section at any time during the period   
beginning on ,december #cj1 #bjbd1 and  
ending on ,january #a1 #bjbg1 in a      
similar manner as such provisions apply 
to rural community hospitals described  
in paragraph 7#d74  4  ,passed the      
,senate ,may #bj1 #bjbf4,secretary