I 

111TH CONGRESS 

1ST SESSION H. R. 3806 

To amend the Medicare Prescription Drug, Improvement, and Modernization 

Act of 2003 to extend and expand the Medicare rural community hospital 

demonstration program. 

IN THE HOUSE OF REPRESENTATIVES 

OCTOBER 14, 2009 

Mr. MORAN of Kansas introduced the following bill; which was referred to the 

Committee on Ways and Means 

A BILL 

To amend the Medicare Prescription Drug, Improvement, 

and Modernization Act of 2003 to extend and expand 

the Medicare rural community hospital demonstration 

program. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Enhanced Rural 

5 Health Care Extension Act of 2009’’. 


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1 SEC. 2. EXTENSION AND EXPANSION OF THE MEDICARE 

2 RURAL COMMUNITY HOSPITAL DEMONSTRA3 TION PROGRAM. 

4 (a) SELECTION OF DEMONSTRATION AREAS.—Sec5 tion 410A(a)(2) of the Medicare Prescription Drug, Im6 provement, and Modernization Act of 2003 (Public Law 

7 108–173; 42 U.S.C. 1395ww note) is amended to read as 

8 follows: 

9 ‘‘(2) DEMONSTRATION AREAS.—The dem10 onstration program shall be conducted in rural areas 

11 selected by the Secretary in the 15 States with the 

12 lowest population densities, as determined by the 

13 Secretary using the Statistical Abstract of the 

14 United States: 2009 (published by the Bureau of the 

15 Census).’’. 

16 (b) SELECTION OF HOSPITALS.—Section 410A(a)(4) 

17 of such Act is amended by striking ‘‘15’’ and inserting 

18 ‘‘30’’. 

19 (c) DURATION.—Section 410A(a)(5) of such Act is 

20 amended by striking ‘‘5-year’’ and inserting ‘‘10-year’’. 

21 (d) REPORTS.—Section 410A(e) of such Act is 

22 amended to read as follows: 

23 ‘‘(e) REPORTS.—The Secretary shall submit to Con24 gress— 

25 ‘‘(1) within 6 months after the date of the en26 actment of the Enhanced Rural Health Care ExtenVerDate Nov 24 2008 22:12 Oct 15, 2009 Jkt 089200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H3806.IH H3806

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1 sion Act of 2009, an interim report on the operation 

2 of the demonstration program under this section; 

3 and 

4 ‘‘(2) within 6 months after the completion of 

5 the demonstration program, a final report on the op6 eration of such program. 

7 Each report under this subsection shall include rec8 ommendations for such legislation and administrative ac9 tion as the Secretary determines to be appropriate.’’. 

10 (e) EXCEPTION FOR CERTAIN RURAL COMMUNITY

11 HOSPITALS.—If, on the date of the enactment of this Act, 

12 a rural community hospital (as defined in section 

13 410A(f)(1) of the Medicare Prescription Drug, Improve14 ment, and Modernization Act of 2003 (Public Law 108– 

15 173; 42 U.S.C. 1395ww note)) is participating in the rural 

16 community hospital demonstration program established 

17 under section 410A of such Act and is located within a 

18 State that is not identified by the Secretary of Health and 

19 Human Services under section 410A(a)(2) of such Act (as 

20 amended by this section), the Secretary shall provide for 

21 the continued participation of such hospital in such dem22 onstration program. 

23 (f) TECHNICAL AMENDMENTS.—Section 410A of 

24 such Act is amended— 

25 (1) in subsection (b)— 


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1 (A) in paragraph (1)(B)(ii), by striking 

2 ‘‘2)’’ and inserting ‘‘2))’’; and 

3 (B) in paragraph (2)— 

4 (i) in subparagraph (A), by inserting 

5 ‘‘cost’’ before ‘‘reporting period’’; and 

6 (ii) in subparagraph (B), by inserting 

7 ‘‘cost’’ before ‘‘reporting period’’ the first 

8 place it appears; and 

9 (2) in subsection (f)(1)— 

10 (A) in subparagraph (A)(ii), by striking 

11 ‘‘paragraph (2)’’ and inserting ‘‘subparagraph 

12 (B)’’; and 

13 (B) in subparagraph (B), by striking 

14 ‘‘paragraph (1)(B)’’ and inserting ‘‘subpara15 graph (A)(ii)’’. 

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