I 
117TH CONGRESS 
1ST SESSION H. R. 1838 
To amend title XVIII of the Social Security Act to improve rural health 
clinic payments, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
MARCH 11, 2021 
Mr. LUETKEMEYER
(for himself, Mr. SESSIONS, Mr. JACKSON, Mr. 
ARRINGTON, Mr. GUEST, and Mr. LONG) introduced the following bill; 
which was referred to the Committee on Energy and Commerce, and in 
addition to the Committee on Ways and Means, for a period to be subse-
quently determined by the Speaker, in each case for consideration of such 
provisions as fall within the jurisdiction of the committee concerned 
A BILL 
To amend title XVIII of the Social Security Act to improve 
rural health clinic payments, and for other purposes. 
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 ‘‘Affordable Access to 
Rural Health Care Act’’. 
SEC. 2. IMPROVING RURAL HEALTH CLINIC PAYMENTS. 
(a) IN GENERAL.—Section 1833(f) of the Social Se-
curity Act (42 U.S.C. 1395l(f)) is amended— 
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(1) by adding at the end the following new 
paragraphs: 
‘‘(4) EXCEPTION.—In establishing limits under 
subsection (a) on payment for rural health clinic 
services provided by rural health clinics which sub-
mits to the Secretary a certification that the hospital 
has a binding written agreement with an outside un-
related party for the construction or purchase of 
such rural health clinic before March 30, 2021, the 
Secretary shall— 
‘‘(A) during the first year during which 
such rural health clinic furnishes such services, 
make payments to such rural health clinic with-
out the application of such limits; and 
‘‘(B) during any subsequent year, make 
payments in accordance with this subsection. 
‘‘(5) AUDIT.—Not later than 60 days after the 
date of the enactment of this paragraph, the Sec-
retary shall audit the compliance with requirements 
of paragraph (4) with respect to each rural health 
clinic to which such paragraph applies. If the Sec-
retary finds as a result of an audit under this clause 
that the applicable requirements were not met with 
respect to such rural health clinic, the rural health 
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clinic shall receive payments under this subsection 
notwithstanding such paragraph.’’. 
(b) UTILIZATION OF MEDICARE ENROLLMENT AP-
PLICATION FORM.—The Secretary of Health and Human 
Services shall utilize Form CMS 855A (or any successor 
Medicare Enrollment Application form) to review the eligi-
bility of rural health clinics (as defined in section 
1861(aa)(2) of the Social Security Act (42 U.S.C. 
1395x(aa)(2))) to receive payments pursuant to the mid- 
build exception described in section 1833(f)(4) of such Act 
(42 U.S.C. 1935l(f)(4)). 
(c) REPORT.—Not later than 120 days after the date 
of the enactment of this Act, the Secretary of Health and 
Human Services shall submit to Congress a report on the 
findings of the audit described in paragraph (5) of section 
1833(f) of the Social Security Act (42 U.S.C. 1935l(f)). 
Æ 
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