I 
110TH CONGRESS 
1ST SESSION H. R. 2159 
To amend part C of title XVIII of the Social Security Act to provide 
for a minimum payment rate by Medicare Advantage organizations for 
services furnished by a critical access hospital and a rural health clinic 
under the Medicare Program. 
IN THE HOUSE OF REPRESENTATIVES 
MAY 3, 2007 
Mr. KIND (for himself and Mrs. MCMORRIS RODGERS) introduced the fol-
lowing bill; which was referred to the Committee on Ways and Means, 
and in addition to the Committee on Energy and Commerce, for a period 
to be subsequently determined by the Speaker, in each case for consider-
ation of such provisions as fall within the jurisdiction of the committee 
concerned 
A BILL 
To amend part C of title XVIII of the Social Security Act 
to provide for a minimum payment rate by Medicare 
Advantage organizations for services furnished by a crit-
ical access hospital and a rural health clinic under the 
Medicare Program. 
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 ‘‘Rural Health Services 
Preservation Act of 2007’’. 
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SEC. 2. MINIMUM PAYMENT RATE BY MEDICARE ADVAN-
TAGE ORGANIZATIONS FOR SERVICES FUR-
NISHED BY A CRITICAL ACCESS HOSPITAL 
AND A RURAL HEALTH CLINIC. 
(a) IN GENERAL.—Section 1857(e) of the Social Se-
curity Act (42 U.S.C. 1395w–27(e)) is amended by adding 
at the end the following: 
‘‘(4) MINIMUM PAYMENT RATE FOR SERVICES 
FURNISHED BY A CRITICAL ACCESS HOSPITAL AND 
A RURAL HEALTH CLINIC.—A contract under this 
section between an MA organization and the Sec-
retary for the offering of an MA plan shall require 
the organization to provide for a payment rate under 
the plan for inpatient and outpatient critical access 
hospital services and rural health clinic services fur-
nished to enrollees of the plan and for extended care 
services furnished by a critical access hospital under 
an agreement entered into under section 1883 to 
such enrollees (whether or not the services are fur-
nished pursuant to an agreement between such orga-
nization and a critical access hospital or a rural 
health clinic) that is not less than— 
‘‘(A) the applicable payment rate estab-
lished under part A or part B (which includes 
the payment of an interim rate and a subse-
quent cost reconciliation) with respect to the 
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critical access hospital for such inpatient, out-
patient, and extended care services or the rural 
health clinic for such rural health clinic serv-
ices; or 
‘‘(B) if the critical access hospital or the 
rural health clinic determines appropriate, 103 
percent of the applicable interim payment rate 
established under part A or part B with respect 
to the critical access hospital for such inpatient, 
outpatient, and extended care services or the 
rural health clinic for such rural health clinic 
services.’’. 
(b) EFFECTIVE DATE.—The amendments made by 
this section shall apply to Medicare Advantage contract 
years beginning on or after January 1, 2008. 
Æ 
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