lished in the Federal Register on February 
27, 1992 (57 Fed. Reg. 6725)); 
‘‘(iii) a hospital that is classified as a 
rural, regional, or national referral center under 
section 1886(d)(5)(C) of the Social Security 
Act; and 
‘‘(iv) a hospital that is a sole community 
hospital 
(as 
defined 
in 
section 
1886(d)(5)(D)(iii) of the Social Security Act). 
‘‘(B) For purposes of subparagraph (A), the 
fact that a clinic, facility, or hospital has been geo-
graphically reclassified under the Medicare program 
under title XVIII of the Social Security Act shall not 
preclude a hospital from being considered a rural en-
tity under clause (i) or (ii) of subparagraph (A).’’. 
(c) CONFORMING AMENDMENTS.—Section 1602 of 
the Public Health Service Act (42 U.S.C. 300q–2) is 
amended— 
(1) in subsection (b)(2)(D), by inserting ‘‘or 
1603(a)(2)(B)’’ after ‘‘1601(a)(2)(B)’’; and 
(2) in subsection (d)— 
(A) in paragraph (1)(C), by striking ‘‘sec-
tion 1601(a)(2)(B)’’ and inserting ‘‘sections 
1601(a)(2)(B) and 1603(a)(2)(B)’’; and 
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(B) in paragraph (2)(A), by inserting ‘‘or 
1603(a)(2)(B)’’ after ‘‘1601(a)(2)(B)’’. 
SEC. 403. RURAL HEALTH QUALITY ADVISORY COMMISSION 
AND DEMONSTRATION PROJECTS. 
(a) RURAL HEALTH QUALITY ADVISORY COMMIS-
SION.— 
(1) 
ESTABLISHMENT.—Not 
later 
than 
months after the date of the enactment of this Act, 
the Secretary of Health and Human Services (in this 
section referred to as the ‘‘Secretary’’) shall estab-
lish a commission to be known as the Rural Health 
Quality Advisory Commission (in this section re-
ferred to as the ‘‘Commission’’). 
(2) DUTIES OF COMMISSION.— 
(A) NATIONAL
PLAN.—The Commission 
shall develop, coordinate, and facilitate imple-
mentation of a national plan for rural health 
quality improvement. The national plan shall— 
(i) identify objectives for rural health 
quality improvement; 
(ii) identify strategies to eliminate 
known gaps in rural health system capacity 
and improve rural health quality; and 
(iii) provide for Federal programs to 
identify opportunities for strengthening 
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and aligning policies and programs to im-
prove rural health quality. 
(B) 
DEMONSTRATION
PROJECTS.—The 
Commission shall design demonstration projects 
to test alternative models for rural health qual-
ity improvement, including with respect to both 
personal and population health. 
(C) MONITORING.—The Commission shall 
monitor progress toward the objectives identi-
fied pursuant to paragraph (1)(A). 
(3) MEMBERSHIP.— 
(A) NUMBER.—The Commission shall be 
composed of 11 members appointed by the Sec-
retary. 
(B) SELECTION.—The Secretary shall se-
lect the members of the Commission from 
among individuals with significant rural health 
care and health care quality expertise, including 
expertise in clinical health care, health care 
quality research, population or public health, or 
purchaser organizations. 
(4) CONTRACTING AUTHORITY.—Subject to the 
availability of funds, the Commission may enter into 
contracts and make other arrangements, as may be 
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