To amend the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 to extend the Rural Community Hospital Demonstration Program.

Summary: Rural Community Hospital Demonstration Extension Act of 2009 - Amends the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 to direct the Secretary of Health and Human Services (HHS) to extend for an additional five years the rural community hospital demonstration program.

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Rural Community Hospital 
Demonstration Extension Act of 2009''.

SEC. 2. EXTENSION OF RURAL COMMUNITY HOSPITAL DEMONSTRATION PROGRAM.

    (a) 5-year Extension.--Section 410A of the Medicare Prescription 
Drug, Improvement, and Modernization Act of 2003 (Public Law 108-173; 
117 Stat. 2272) is amended by adding at the end the following new 
subsection:
    ``(g) 5-Year Extension of Demonstration Program.--
            ``(1) In general.--Subject to the succeeding provisions of 
        this subsection, the Secretary shall conduct the demonstration 
        program under this section for an additional 5-year period (in 
        this section referred to as the `5-year extension period') that 
        begins on the date immediately following the last day of the 
        initial 5-year period under subsection (a)(5).
            ``(2) Expansion of demonstration states.--Notwithstanding 
        subsection (a)(2), during the 5-year extension period, the 
        program shall be conducted in rural areas in any State.
            ``(3) Increase in maximum number of hospitals participating 
        in the demonstration program.--Notwithstanding subsection 
        (a)(4), during the 5-year extension period, not more than 30 
        rural community hospitals may participate in the demonstration 
        program under this section.
            ``(4) Hospitals in demonstration program on date of 
        enactment.--In the case of a rural community hospital that is 
        participating in the demonstration program under this section 
        as of the last day of the initial 5-year period, the 
        Secretary--
                    ``(A) shall provide for the continued participation 
                of such rural community hospital in the demonstration 
                program during the 5-year extension period unless the 
                rural community hospital makes an election, in such 
                form and manner as the Secretary may specify, to 
                discontinue such participation; and
                    ``(B) in calculating the amount of payment under 
                subsection (b) to the rural community hospital for 
                covered inpatient hospital services furnished by the 
                hospital during such 5-year extension period, shall 
                substitute, under paragraph (1)(A) of such subsection--
                            ``(i) the reasonable costs of providing 
                        such services for discharges occurring in the 
                        first cost reporting period beginning on or 
                        after the first day of the 5-year extension 
                        period, for
                            ``(ii) the reasonable costs of providing 
                        such services for discharges occurring in the 
                        first cost reporting period beginning on or 
                        after the implementation of the demonstration 
                        program.''.
    (b) Conforming Amendments.--
            (1) Duration.--Subsection (a)(5) of section 410A of the 
        Medicare Prescription Drug, Improvement, and Modernization Act 
        of 2003 (Public Law 108-173; 117 Stat. 2272) is amended by 
        inserting ``(in this section referred to as the `initial 5-year 
        period') and, as provided in subsection (g), for the 5-year 
        extension period'' after ``5-year period''.
            (2) Additional report.--Subsection (e) of section 410A of 
        the Medicare Prescription Drug, Improvement, and Modernization 
        Act of 2003 (Public Law 108-173; 117 Stat. 2272) is amended to 
        read as follows:
    ``(e) Reports.--
            ``(1) Report on initial 5-year period.--Not later than 6 
        months after the last day of the initial 5-year period, the 
        Secretary shall submit to Congress a report on the conduct of 
        the demonstration program under this section during such 
        period, together with recommendations for such legislation and 
        administrative action as the Secretary determines to be 
        appropriate.
            ``(2) Final report.--Not later than 6 months after the last 
        day of the 5-year extension period, the Secretary shall submit 
        to Congress a report on the demonstration program under this 
        section, together with recommendations for such legislation and 
        administrative action as the Secretary determines to be 
        appropriate.''.
    (c) Technical Amendments.--
            (1) Subsection (b) of section 410A of the Medicare 
        Prescription Drug, Improvement, and Modernization Act of 2003 
        (Public Law 108-173; 117 Stat. 2272) is amended--
                    (A) in paragraph (1)(B)(ii), by striking ``2)'' and 
                inserting ``2))''; and
                    (B) in paragraph (2), by inserting ``cost'' before 
                ``reporting period'' the first place such term appears 
                in each of subparagraphs (A) and (B).
            (2) Subsection (f)(1) of section 410A of the Medicare 
        Prescription Drug, Improvement, and Modernization Act of 2003 
        (Public Law 108-173; 117 Stat. 2272) is amended--
                    (A) in subparagraph (A)(ii), by striking 
                ``paragraph (2)'' and inserting ``subparagraph (B)''; 
                and
                    (B) in subparagraph (B), by striking ``paragraph 
                (1)(B)'' and inserting ``subparagraph (A)(ii)''.