I
106TH CONGRESS
2D SESSION
H. R. 4677
To promote access to health care services in rural areas.
IN THE HOUSE OF REPRESENTATIVES
JUNE 15, 2000
Mr. FOLEY (for himself, Mr. LUCAS of Oklahoma, Mr. TANNER, Mr. NUSSLE,
Mr. STENHOLM, Mr. MCINTYRE, Mr. POMEROY, Mr. BERRY, and Mr.
DICKEY) introduced the following bill; which was referred to the Com-
mittee on Ways and Means, and in addition to the Committee on Com-
merce, for a period to be subsequently determined by the Speaker, in
each case for consideration of such provisions as fall within the jurisdic-
tion of the committee concerned
A BILL
To promote access to health care services in rural areas.
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled,
SECTION 1. SHORT TITLE; TABLE OF CONTENTS.
(a) SHORT TITLE.—This Act may be cited as the
‘‘Health Care Access and Rural Equality Act of 2000’’.
(b) TABLE OF CONTENTS.—The table of contents of
this Act is as follows:
Sec. 1. Short title; table of contents.
TITLE I—INCREASE IN MARKET BASKET PERCENTAGE
ADJUSTMENT FOR RURAL HOSPITALS
Sec. 101. Increase in market basket percentage adjustment for rural hospitals.
TITLE II—CAPITAL RELIEF FOR RURAL HEALTH CARE
INFRASTRUCTURE
Sec. 201. Capital infrastructure revolving loan program.
TITLE III—REFINEMENT OF THE MEDICARE DEPENDENT, SMALL
RURAL HOSPITAL PROGRAM
Sec. 301. Making the medicare dependent, small rural hospital program perma-
nent.
Sec. 302. Option to base eligibility on discharges during any of the 3 most re-
cent audited cost reporting periods.
TITLE IV—EXEMPTION FOR MEDICARE SWING BED HOSPITALS
Sec. 401. Exemption of medicare swing bed hospitals from the prospective pay-
ment system for skilled nursing facilities.
TITLE V—TREATMENT OF PHYSICIAN PATHOLOGY SERVICES
Sec. 501. Treatment of certain physician pathology services under medicare.
TITLE VI—MEDICAID PAYMENT CORRECTION FOR CERTAIN
RURAL HEALTH CLINICS
Sec. 601. Limit on certain medicaid recoupments and disallowances.
TITLE VII—TECHNICAL CORRECTIONS TO THE BALANCED
BUDGET REFINEMENT ACT
Sec. 701. Payments to critical access hospitals for clinical diagnostic laboratory
tests.
Sec. 702. All-inclusive payment option for outpatient critical access hospital
services.
Sec. 703. Extension of option to use rebased target amounts to all sole commu-
nity hospitals.
Sec. 704. Grants for upgrading data systems.
TITLE I—INCREASE IN MARKET
BASKET 
PERCENTAGE 
AD-
JUSTMENT FOR RURAL HOS-
PITALS
SEC. 101. INCREASE IN MARKET BASKET PERCENTAGE AD-
JUSTMENT FOR RURAL HOSPITALS.
Section 1886(b)(3)(B)(i) of the Social Security Act
(42 U.S.C. 1395ww(b)(3)(B)(i)) (as amended by section
406 of the Medicare, Medicaid, and SCHIP Balanced
Budget Refinement Act of 1999 (113 Stat. 1501A–373),
as enacted into law by section 1000(a)(6) of Public Law
106–113) is amended—
(1) in subclause (XVI)—
(A) by striking ‘‘(other than sole commu-
nity hospitals)’’ and inserting ‘‘(other than any
hospital that is located in a rural area and that
has less than 100 beds, is classified under sub-
section (d)(5)(C), or is a sole community hos-
pital (as defined in subsection (d)(5)(D)(iii)))’’;
and
(B) by striking ‘‘increase for sole commu-
nity hospitals’’ and inserting ‘‘increase for any
hospital that is located in a rural area and that
has less than 100 beds, is classified under sub-
section (d)(5)(C), or is a sole community hos-
pital (as defined in subsection (d)(5)(D)(iii))’’;
and
(2) in subclause (XVII)—
(A) by inserting ‘‘(other than any hospital
that is located in a rural area and that has less
than 100 beds, is classified under subsection
(d)(5)(C), or is a sole community hospital (as
‘‘(A) the acquisition of land necessary for
the capital improvements;
‘‘(B) the construction, renovation, or mod-
ernization of any building;
‘‘(C) the acquisition or repair of fixed or
major movable equipment; and
‘‘(D) such other project expenses as the
Secretary determines appropriate.
‘‘(2) AUTHORITY TO GUARANTEE LOANS.—
‘‘(A) IN
GENERAL.—The Secretary may
guarantee the payment of principal and interest
for loans to rural entities for projects for cap-
ital improvements described in paragraph (1) to
non-Federal lenders.
‘‘(B) INTEREST SUBSIDIES.—In the case
of a guarantee of any loan to a rural entity
under subparagraph (A), the Secretary may pay
to the holder of such loan and for and on behalf
of the project for which the loan was made,
amounts sufficient to reduce by not more than
3 percent of the net effective interest rate oth-
erwise payable on such loan.
‘‘(b) AMOUNT OF LOAN.—The principal amount of
a loan directly made or guaranteed under subsection (a)
for a project for capital improvement may not exceed
$5,000,000.
‘‘(c) FUNDING LIMITATIONS.—
‘‘(1) GOVERNMENT
CREDIT
SUBSIDY
EXPO-
SURE.—The total of the Government credit subsidy
exposure under the Credit Reform Act of 1990 scor-
ing protocol with respect to the loans outstanding at
any time with respect to which guarantees have been
issued, or which have been directly made, under sub-
section (a) may not exceed $50,000,000 per year.
‘‘(2) TOTAL AMOUNTS.—Subject to paragraph
(1), the total of the principal amount of all loans di-
rectly made or guaranteed under subsection (a) may
not exceed $250,000,000 per year.
‘‘(d) ADDITIONAL ASSISTANCE.—
‘‘(1) NONREPAYABLE
GRANTS.—Subject to
paragraph (2), the Secretary may make a grant to
a rural entity, in an amount not to exceed $50,000,
for purposes of capital assessment and business
planning.
‘‘(2) LIMITATION.—The cumulative total of
grants awarded under this subsection may not ex-
ceed $2,500,000 per year.
‘‘(e) TERMINATION OF AUTHORITY.—The Secretary
may not directly make or guarantee any loan under sub-
section (a) or make a grant under subsection (d) after
September 30, 2005.’’.
(b) RURAL ENTITY DEFINED.—Section 1624 of the
Public Health Service Act (42 U.S.C. 300s–3) is amended
by adding at the end the following new paragraph:
‘‘(15)(A) The term ‘rural entity’ includes—
‘‘(i) a rural health clinic, as defined in sec-
tion 1861(aa)(2) of the Social Security Act;
‘‘(ii) any medical facility with at least 1,
but less than 50 beds that is located in—
‘‘(I) a county that is not part of a
metropolitan statistical area; or
‘‘(II) a rural census tract of a metro-
politan statistical area (as determined
under the most recent modification of the
Goldsmith Modification, originally pub-
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
(B) in paragraph (2)(A), by inserting ‘‘or
1603(a)(2)(B)’’ after ‘‘1601(a)(2)(B)’’.
TITLE III—REFINEMENT OF THE
MEDICARE 
DEPENDENT,
SMALL 
RURAL 
HOSPITAL
PROGRAM
SEC. 301. MAKING THE MEDICARE DEPENDENT, SMALL
RURAL HOSPITAL PROGRAM PERMANENT.
(a) 
PAYMENT
METHODOLOGY.—Section
1886(d)(5)(G) of the Social Security Act (42 U.S.C.
1395ww(d)(5)(G)) (as amended by section 404(a) of the
Medicare, Medicaid, and SCHIP Balanced Budget Refine-
ment Act of 1999 (113 Stat. 1501A–372), as enacted into
law by section 1000(a)(6) of Public Law 106–113) is
amended—
(1) in clause (i), by striking ‘‘and before Octo-
ber 1, 2006,’’; and
(2) in clause (ii)(II), by striking ‘‘and before
October 1, 2006,’’.
(b) CONFORMING AMENDMENTS.—
(1) TARGET AMOUNT.—Section 1886(b)(3)(D)
of 
the 
Social 
Security 
Act 
(42 
U.S.C.
1395ww(b)(3)(D)) (as amended by section 404(b)(1)
of the Medicare, Medicaid, and SCHIP Balanced
Budget Refinement Act of 1999 (113 Stat. 1501A–
372), as enacted into law by section 1000(a)(6) of
Public Law 106–113) is amended—
(A) in the matter preceding clause (i), by
striking ‘‘and before October 1, 2006,’’; and
(B) in clause (iv), by striking ‘‘through fis-
cal year 2005,’’ and inserting ‘‘or any subse-
quent fiscal year,’’.
(2) PERMITTING HOSPITALS TO DECLINE RE-
CLASSIFICATION.—Section 13501(e)(2) of the Omni-
bus Budget Reconciliation Act of 1993 (42 U.S.C.
1395ww note) (as amended by section 404(b)(2) of
the Medicare, Medicaid, and SCHIP Balanced
Budget Refinement Act of 1999 (113 Stat. 1501A–
372), as enacted into law by section 1000(a)(6) of
Public Law 106–113) is amended by striking ‘‘or
fiscal year 2000 through fiscal year 2005’’ and in-
serting ‘‘fiscal year 2000, or any subsequent fiscal
year,’’.
SEC. 302. OPTION TO BASE ELIGIBILITY ON DISCHARGES
DURING ANY OF THE 3 MOST RECENT AU-
DITED COST REPORTING PERIODS.
(a) OPTION TO BASE ELIGIBILITY ON DISCHARGES
DURING ANY OF THE 3 MOST RECENT AUDITED COST
REPORTING PERIODS.—Section 1886(d)(5)(G)(iv)(IV) of
the 
Social 
Security 
Act 
(42 
U.S.C.
1395ww(d)(5)(G)(iv)(IV)) is amended by inserting ‘‘, or
any of the 3 most recent audited cost reporting periods,’’
after ‘‘1987’’.
(b) EFFECTIVE DATE.—The amendments made by
this section shall apply with respect to cost reporting peri-
ods beginning on or after the date of enactment of this
Act.
TITLE 
IV—EXEMPTION 
FOR
MEDICARE SWING BED HOS-
PITALS
SEC. 401. EXEMPTION OF MEDICARE SWING BED HOS-
PITALS FROM THE PROSPECTIVE PAYMENT
SYSTEM FOR SKILLED NURSING FACILITIES.
(a) EXEMPTION FOR MEDICARE SWING BED HOS-
PITALS.—
(1) IN
GENERAL.—Section 1888(e)(7) of the
Social Security Act (42 U.S.C. 1395yy(e)(7)(A)) is
amended—
(A) in the heading, by striking ‘‘TRANSI-
TION’’ and inserting ‘‘EXEMPTION’’;
(B) by striking subparagraph (A) and in-
serting the following new subparagraph:
‘‘(A) IN GENERAL.—The prospective pay-
ment system under this subsection shall not
apply to items and services provided by a facil-
ity described in subparagraph (B).’’; and
(C) in subparagraph (B), by striking ‘‘, for
which payment’’ and all that follows before the
period.
(2) EFFECTIVE DATE.—The amendments made
by paragraph (1) shall take effect as if included in
the enactment of section 4432 of the Balanced
Budget Act of 1997 (Public Law 105–133; 111
Stat. 414).
(b) REPEAL OF BBRA AMENDMENTS.—
(1) IN GENERAL.—Section 408 of the Medicare,
Medicaid, and SCHIP Balanced Budget Refinement
Act of 1999 (113 Stat. 1501A–375), as enacted into
law by section 1000(a)(6) of Public Law 106–113,
and the amendments made by such section are re-
pealed.
(2) EFFECTIVE
DATE.—The Secretary shall
apply and administer the Social Security Act as if
section 408 of the Medicare, Medicaid, and SCHIP
Balanced Budget Refinement Act of 1999 (113 Stat.
1501A–375), as enacted into law by section
1000(a)(6) of Public Law 106–113, and the amend-
ments made by such section had never been enacted
into law.
TITLE V—TREATMENT OF PHYSI-
CIAN PATHOLOGY SERVICES
SEC. 501. TREATMENT OF CERTAIN PHYSICIAN PATHOLOGY
SERVICES UNDER MEDICARE.
(a) IN GENERAL.—Notwithstanding any other provi-
sion of law, when an independent laboratory, under a
grandfathered arrangement with a hospital, furnishes the
technical component of a physician pathology service with
respect to a fee-for-service medicare beneficiary who is an
inpatient of the hospital, such component shall be treated
as a service for which payment shall be made to the lab-
oratory under section 1848 of the Social Security Act (42
U.S.C. 1395w–4) and not as an inpatient hospital service
for which payment is made to the hospital under section
1886(d) of such Act (42 U.S.C. 1395ww(d)).
(b) DEFINITIONS.—For purposes of this section—
(1) the term ‘‘grandfathered arrangement’’
means an arrangement between an independent lab-
oratory and a hospital—
(A) that was in effect as of July 22, 1999,
even if such arrangement is subsequently re-
newed; and
(B) under which the laboratory furnishes
the technical component of physician pathology
services with respect to hospital inpatients and
submits a claim for payment for such compo-
nent to a medicare carrier (and not to the hos-
pital);
(2) the term ‘‘fee-for-service medicare bene-
ficiary’’ means an individual who—
(A) is entitled to benefits under part A of
title XVIII of the Social Security Act (42
U.S.C. 1395c et seq.); and
(B) is not enrolled in a Medicare+Choice
plan under part C of such Act (42 U.S.C.
1395w–21 et seq.), a plan offered by an eligible
organization under section 1876 of such Act
(42 U.S.C. 1395mm), or a medicare managed
care demonstration project; and
(3) the term ‘‘medicare carrier’’ means an orga-
nization with a contract under section 1842 of such
Act (42 U.S.C. 1395u).
(c) EFFECTIVE DATE.—This section shall apply to
services furnished on or after July 22, 1999.
TITLE VI—MEDICAID PAYMENT
CORRECTION FOR CERTAIN
RURAL HEALTH CLINICS
SEC. 601. LIMIT ON CERTAIN MEDICAID RECOUPMENTS
AND DISALLOWANCES.
(a) IN GENERAL.—Notwithstanding any other provi-
sion of law—
(1) a State plan approved under title XIX of
the Social Security Act may not recoup or deny pay-
ments under such plan that—
(A) are for rural health clinic services (as
defined in section 1905(l)(1) of such title) fur-
nished on or after January 1, 1998, and before
October 1, 2000; and
(B) are alleged overpayments due to a de-
termination that the amendment made by sec-
tion 4205(a)(1)(A) of the Balanced Budget Act
of 1997 (relating to per visit limits for provider-
based clinics under medicare) applies to rural
health clinic services furnished under such title
XIX; and
(2) the Secretary of Health and Human Serv-
ices (in this section referred to as the ‘‘Secretary’’)
may not withhold, suspend, disallow, or deny Fed-
eral financial participation under section 1903 of the
Social Security Act (42 U.S.C. 1396b) with respect
to alleged overpayments described in paragraph (1).
(b) PAYMENT OF AMOUNTS RECOUPED, DENIED, OR
DISALLOWED.—If, before the date of the enactment of
this section—
(1) a State plan has recouped or denied pay-
ments described in subsection (a)(1), or
(2) the Secretary has withheld, suspended, dis-
allowed, or denied Federal financial participation
under title XIX of the Social Security Act with re-
spect to such payments,
the State plan or the Secretary, as the case may be, shall
pay the amounts recouped, denied, withheld, suspended,
or disallowed, to the rural health clinic or the State, as
the case may be.
TITLE VII—TECHNICAL CORREC-
TIONS 
TO 
THE 
BALANCED
BUDGET REFINEMENT ACT
SEC. 701. PAYMENTS TO CRITICAL ACCESS HOSPITALS FOR
CLINICAL DIAGNOSTIC LABORATORY TESTS.
(a) PAYMENT
ON COST BASIS WITHOUT BENE-
FICIARY COST-SHARING.—
(1) IN GENERAL.—Section 1833(a)(6) of the
Social Security Act (42 U.S.C. 1395l(a)(6)) is
amended by inserting ‘‘(including clinical diagnostic
laboratory services furnished by a critical access hos-
pital)’’ after ‘‘outpatient critical access hospital serv-
ices’’.
(2) NO BENEFICIARY COST-SHARING.—
(A) IN GENERAL.—Section 1834(g) of the
Social Security Act (42 U.S.C. 1395m(g)) is
amended by inserting ‘‘(except that in the case
of clinical diagnostic laboratory services fur-
nished by a critical access hospital the amount
of payment shall be equal to 100 percent of the
reasonable costs of the critical access hospital
in providing such services)’’ before the period at
the end.
(B) BBRA AMENDMENT.—Section 1834(g)
of 
the 
Social 
Security 
Act 
(42 
U.S.C.
1395m(g)) (as amended by section 403(d) of
the Medicare, Medicaid, and SCHIP Balanced
Budget Refinement Act of 1999 (113 Stat.
1501A–371), as enacted into law by section
1000(a)(6) 
of 
Public 
Law 
106–113) 
is
amended—
(i) in paragraph (1), by inserting
‘‘(except that in the case of clinical diag-
nostic laboratory services furnished by a
critical access hospital the amount of pay-
ment shall be equal to 100 percent of the
reasonable costs of the critical access hos-
pital in providing such services)’’ after
‘‘such services,’’; and
(ii) in paragraph (2)(A), by inserting
‘‘(except that in the case of clinical diag-
nostic laboratory services furnished by a
critical access hospital the amount of pay-
ment shall be equal to 100 percent of the
reasonable costs of the critical access hos-
pital in providing such services)’’ before
the period at the end.
(b) 
CONFORMING
AMENDMENTS.—Paragraphs
(1)(D)(i) and (2)(D)(i) of section 1833(a) of the Social
Security 
Act 
(42 
U.S.C. 
1395l(a)(1)(D)(i);
1395l(a)(2)(D)(i)) (as amended by section 403(e) of the
Medicare, Medicaid, and SCHIP Balanced Budget Refine-
ment Act of 1999 (113 Stat. 1501A–371), as enacted into
law by section 1000(a)(6) of Public Law 106–113) are
each amended by striking ‘‘or which are furnished on an
outpatient basis by a critical access hospital’’.
(c) TECHNICAL AMENDMENT.—Section 403(d)(2) of
the Medicare, Medicaid, and SCHIP Balanced Budget Re-
finement Act of 1999 (113 Stat. 1501A–371), as enacted
into law by section 1000(a)(6) of Public Law 106–113,
is amended by striking ‘‘subsection (a)’’ and inserting
‘‘paragraph (1)’’.
(d) EFFECTIVE DATES.—
(1) IN GENERAL.—Except as provided in para-
graph (2), the amendments made by this section
shall apply to services furnished on or after Novem-
ber 29, 1999.
(2) BBRA AND
TECHNICAL
AMENDMENTS.—
The amendments made by subsections (a)(2)(B) and
(c) shall take effect as if included in the enactment
of section 403(d) of the Medicare, Medicaid, and
SCHIP Balanced Budget Refinement Act of 1999
(113 Stat. 1501A–371), as enacted into law by sec-
tion 1000(a)(6) of Public Law 106–113.
SEC. 702. ALL-INCLUSIVE PAYMENT OPTION FOR OUT-
PATIENT CRITICAL ACCESS HOSPITAL SERV-
ICES.
(a) ALL-INCLUSIVE PAYMENT OPTION
FOR OUT-
PATIENT CRITICAL ACCESS HOSPITAL SERVICES.—Sec-
tion 1834(g) (42 U.S.C. 1395m(g)) (as amended by sec-
tion 601 of this Act and section 403(d) of the Medicare,
Medicaid, and SCHIP Balanced Budget Refinement Act
of 1999 (113 Stat. 1501A–371), as enacted into law by
section 1000(a)(6) of Public Law 106–113) is amended—
(1) by striking paragraph (1) and inserting the
following new paragraph:
‘‘(1) ELECTION OF CAH.—At the election of a
critical access hospital, the amount of payment for
outpatient critical access hospital services under this
part shall be determined under paragraph (2) or (3),
such amount determined under either paragraph
without regard to the amount of the customary or
other charge.’’; and
(2) by striking paragraph (3) and inserting the
following new paragraph:
‘‘(3) ALL-INCLUSIVE RATE.—If a critical access
hospital elects this paragraph to apply, with respect
to both facility services and professional services,
there shall be paid amounts equal to the reasonable
costs of the critical access hospital in providing such
services (except that in the case of clinical diagnostic
laboratory services furnished by a critical access hos-
pital the amount of payment shall be equal to 100
percent of the reasonable costs of the critical access
hospital in providing such services), less the amount
that such hospital may charge as described in sec-
tion 1866(a)(2)(A).’’.
(b) EFFECTIVE DATE.—The amendments made by
subparagraph (a) shall take effect as if included in the
enactment of section 403(d) of the Medicare, Medicaid,
and SCHIP Balanced Budget Refinement Act of 1999
(113 Stat. 1501A–371), as enacted into law by section
1000(a)(6) of Public Law 106–113.
SEC. 703. EXTENSION OF OPTION TO USE REBASED TARGET
AMOUNTS TO ALL SOLE COMMUNITY HOS-
PITALS.
(a) IN GENERAL.—Section 1886(b)(3)(I)(i) of the
Social Security Act (42 U.S.C. 1395ww(b)(3)(I)(i)) (as
added by section 405 of the Medicare, Medicaid, and
SCHIP Balanced Budget Refinement Act of 1999 (113
Stat. 1501A–372), as enacted into law by section
1000(a)(6) of Public Law 106–113) is amended—
(1) in the matter preceding subclause (I)—
(A) by striking ‘‘for its cost reporting pe-
riod beginning during 1999 is paid on the basis
of the target amount applicable to the hospital
under subparagraph (C) and that’’; and
(B) by striking ‘‘such target amount’’ and
inserting ‘‘the amount otherwise determined
under subsection (d)(5)(D)(i)’’;
(2) in subclause (I), by striking ‘‘target amount
otherwise applicable’’ and all that follows through
‘‘target amount’)’’ and inserting ‘‘the amount other-
wise applicable to the hospital under subsection
(d)(5)(D)(i) (referred to in this clause as the ‘sub-
section (d)(5)(D)(i) amount’)’’; and
(3) in each of subclauses (II) and (III), by
striking ‘‘subparagraph (C) target amount’’ and in-
serting ‘‘subsection (d)(5)(D)(i) amount’’.
(b) EFFECTIVE DATE.—The amendments made by
this section shall take effect as if included in the enact-
ment of the Medicare, Medicaid, and SCHIP Balanced
Budget Refinement Act of 1999, as enacted into law by
section 1000(a)(6) of Public Law 106–113.
SEC. 704. GRANTS FOR UPGRADING DATA SYSTEMS.
(a) IN GENERAL.—Part B of title XVI of the Public
Health Service Act (42 U.S.C. 300r et seq.) is amended
by adding at the end the following new section:
‘‘GRANTS FOR UPGRADING DATA SYSTEMS
‘‘SEC. 1611. (a) GRANTS TO HOSPITALS.—The Sec-
retary may make grants to hospitals that have submitted
applications in accordance with subsection (c) to assist eli-
gible small rural hospitals in meeting the costs of estab-
lishing data systems required to meet requirements estab-
lished under the medicare program pursuant to amend-
ments made by the Balanced Budget Act of 1997 and the
Health Insurance Portability and Accountability Act of
1996.
‘‘(b) ELIGIBLE
SMALL
RURAL
HOSPITAL
DE-
FINED.—For purposes of this section, the term ‘eligible
small rural hospital’ means a non-Federal, short-term gen-
eral acute care hospital that—
‘‘(1) is located in a rural area, as defined for
purposes of section 1886(d) of the Social Security
Act; and
‘‘(2) has less than 50 beds.
‘‘(c) APPLICATION.—A hospital seeking a grant
under this section shall submit an application to the Sec-
retary on or before such date and in such form and man-
ner as the Secretary specifies.
‘‘(d) AMOUNT OF GRANT.—A grant to a hospital
under this section may not exceed $50,000.
‘‘(e) USE OF FUNDS.—A hospital receiving a grant
under this section may use the funds for the purchase of
computer software and hardware, the education and train-
ing of hospital staff on computer information systems, the
expenses related to the administrative simplification re-
quirements under part C of title XI of the Social Security
Act, and to offset costs related to the implementation of
prospective payment systems under title XVIII of such
Act.
‘‘(f) REPORTS.—
‘‘(1) INFORMATION.—A hospital receiving a
grant under this section shall furnish the Secretary
with such information as the Secretary may require
to evaluate the project for which the grant is made
and to ensure that the grant is expended for the
purposes for which it is made.
‘‘(2) TIMING OF SUBMISSION.—
‘‘(A) INTERIM
REPORTS.—The Secretary
shall report to the Committee on Commerce of
the House of Representatives and the Com-
mittee on Health, Education, Labor, and Pen-
sions of the Senate at least annually on the
grant program established under this section,
including in such report information on the
number of grants made, the nature of the
projects involved, the geographic distribution of
grant recipients, and such other matters as the
Secretary deems appropriate.
‘‘(B) FINAL REPORT.—The Secretary shall
submit a final report to such committees not
later than 180 days after the completion of all
of the projects for which a grant is made under
this section.
‘‘(g) AUTHORIZATION OF APPROPRIATIONS.—There
are authorized to be appropriated such sums as may be
necessary for grants under this section.’’.
(b) CONFORMING AMENDMENT.—Section 1820(g)(3)
of the Social Security Act (42 U.S.C. 1395i–4(g)(3)) (as
added by section 409 of the Medicare, Medicaid, and
SCHIP Balanced Budget Refinement Act of 1999 (113
Stat. 1501A–375), as enacted into law by section
1000(a)(6) of Public Law 106–113) is repealed.
Æ