SEC. 2. EXTENSION AND EXPANSION OF THE MEDICARE 
RURAL COMMUNITY HOSPITAL DEMONSTRA-
TION PROGRAM. 
(a) SELECTION OF DEMONSTRATION AREAS.—Sec-
tion 410A(a)(2) of the Medicare Prescription Drug, Im-
provement, and Modernization Act of 2003 (Public Law 
108–173; 42 U.S.C. 1395ww note) is amended to read as 
follows: 
‘‘(2) 
DEMONSTRATION
AREAS.—The 
dem-
onstration program shall be conducted in rural areas 
selected by the Secretary in the 15 States with the 
lowest population densities, as determined by the 
Secretary using the Statistical Abstract of the 
United States: 2009 (published by the Bureau of the 
Census).’’. 
(b) SELECTION OF HOSPITALS.—Section 410A(a)(4) 
of such Act is amended by striking ‘‘15’’ and inserting 
‘‘30’’. 
(c) DURATION.—Section 410A(a)(5) of such Act is 
amended by striking ‘‘5-year’’ and inserting ‘‘10-year’’. 
(d) REPORTS.—Section 410A(e) of such Act is 
amended to read as follows: 
‘‘(e) REPORTS.—The Secretary shall submit to Con-
gress— 
‘‘(1) within 6 months after the date of the en-
actment of the Enhanced Rural Health Care Exten-
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sion Act of 2009, an interim report on the operation 
of the demonstration program under this section; 
and 
‘‘(2) within 6 months after the completion of 
the demonstration program, a final report on the op-
eration of such program. 
Each report under this subsection shall include rec-
ommendations for such legislation and administrative ac-
tion as the Secretary determines to be appropriate.’’. 
(e) EXCEPTION FOR CERTAIN RURAL COMMUNITY 
HOSPITALS.—If, on the date of the enactment of this Act, 
a rural community hospital (as defined in section 
410A(f)(1) of the Medicare Prescription Drug, Improve-
ment, and Modernization Act of 2003 (Public Law 108– 
173; 42 U.S.C. 1395ww note)) is participating in the rural 
community hospital demonstration program established 
under section 410A of such Act and is located within a 
State that is not identified by the Secretary of Health and 
Human Services under section 410A(a)(2) of such Act (as 
amended by this section), the Secretary shall provide for 
the continued participation of such hospital in such dem-
onstration program. 
(f) TECHNICAL AMENDMENTS.—Section 410A of 
such Act is amended— 
(1) in subsection (b)— 
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(A) in paragraph (1)(B)(ii), by striking 
‘‘2)’’ and inserting ‘‘2))’’; and 
(B) in paragraph (2)— 
(i) in subparagraph (A), by inserting 
‘‘cost’’ before ‘‘reporting period’’; and 
(ii) in subparagraph (B), by inserting 
‘‘cost’’ before ‘‘reporting period’’ the first 
place it appears; and 
(2) in subsection (f)(1)— 
(A) in subparagraph (A)(ii), by striking 
‘‘paragraph (2)’’ and inserting ‘‘subparagraph 
(B)’’; and 
(B) in subparagraph (B), by striking 
‘‘paragraph (1)(B)’’ and inserting ‘‘subpara-
graph (A)(ii)’’. 
Æ 
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