I 
116TH CONGRESS 
1ST SESSION H. R. 3672 
To provide relief for small rural hospitals from inaccurate instructions 
provided by certain medicare administrative contractors. 
IN THE HOUSE OF REPRESENTATIVES 
JULY 10, 2019 
Mr. BRINDISI (for himself, Mr. REED, and Ms. STEFANIK) introduced the 
following bill; which was referred to the Committee on Ways and Means 
A BILL 
To provide relief for small rural hospitals from inaccurate 
instructions provided by certain medicare administrative 
contractors. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Access for Rural Com-
munities Act’’ or the ‘‘ARC Act’’. 
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SEC. 2. RELIEF FOR SMALL RURAL HOSPITALS FROM INAC-
CURATE INSTRUCTIONS PROVIDED BY CER-
TAIN MEDICARE ADMINISTRATIVE CONTRAC-
TORS. 
(a) APPLICATION OF REVISED VOLUME DECREASE 
ADJUSTMENT METHODOLOGY.—Subject to subsection (b), 
in the case of a sole community hospital or a medicare- 
dependent, small rural hospital with respect to which a 
medicare administrative contractor determined a volume 
decrease adjustment applies for any specified cost report-
ing period, at the election of the hospital, the Secretary 
of Health and Human Services shall recalculate the 
amount of the volume decrease adjustment determined by 
the medicare administrative contractor for such hospital 
and specified cost reporting period using the revised vol-
ume decrease adjustment payment methodology for any 
specified cost reporting period requested by the hospital 
in its election. 
(b) LIMITATION.— 
(1) IN
GENERAL.—Subsection (a) shall not 
apply in the case of a sole community hospital or a 
medicare-dependent, small rural hospital for which 
the medicare administrative contractor determina-
tion of the volume decrease adjustment with respect 
to a specified cost reporting period of the hospital is 
administratively final before the date that is three 
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years before the date of the enactment of this sec-
tion. 
(2) ADMINISTRATIVE FINALITY.—For purposes 
of paragraph (1), the date on which the medicare 
administrative contractor determination with respect 
to a volume decrease adjustment for a specified cost 
reporting period is administratively final is the latest 
of the following: 
(A) The date of the contractor determina-
tion (as defined in section 405.1801 of title 42, 
Code of Federal Regulations). 
(B) The date of the final outcome of any 
reopening of the medicare administrative con-
tractor determination under section 405.1885 
of title 42, Code of Federal Regulations. 
(C) The date of the final outcome of the 
final appeal filed by such hospital with respect 
to such volume decrease adjustment for such 
specified cost reporting period. 
(c) DEFINITIONS.—In this section: 
(1) 
MEDICARE
ADMINISTRATIVE
CON-
TRACTOR.—The term ‘‘medicare administrative con-
tractor’’ means the entity that has entered into a 
contract with the Secretary of Health and Human 
Services under section 1874A of the Social Security 
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