II Calendar No. 181 114th CONGRESS 1st Session S. 607 [Report No. 114–102] IN THE SENATE OF THE UNITED STATES February 27, 2015 Mr. Grassley (for himself, Mr. Bennet , Ms. Murkowski , Mr. Moran , Mr. Udall , Mr. Sullivan , Mr. Thune , Mr. Wicker , Mr. Roberts , Mrs. Ernst , Mr. Franken , Mr. Cochran , Mr. Gardner , Mrs. Fischer , and Mr. Rounds ) introduced the following bill; which was read twice and referred to the Committee on Finance July 30, 2015 Reported by Mr. Hatch , with an amendment and an amendment to the title Strike out all after the enacting clause and insert the part printed in italic A BILL To amend title XVIII of the Social Security Act to provide for a five-year extension of the rural community hospital demonstration program, and for other purposes.

1. Short title This Act may be cited as the Rural Community Hospital Demonstration Extension Act of 2015 . 2. Five-year extension of the rural community hospital demonstration program (a) Extension Section 410A of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 ( Public Law 108–173 ; 42 U.S.C. 1395ww note), as amended by sections 3123 and 10313 of the Patient Protection and Affordable Care Act ( Public Law 111–148 ), is amended— (1) in subsection (a)(5), by striking 5-year extension period and inserting 10-year extension period ; and (2) in subsection (g)— (A) in the subsection heading, by striking Five-Year and inserting Ten-Year ; (B) in paragraph (1), by striking additional 5-year and inserting additional 10-year ; and (C) by striking 5-year extension period and inserting 10-year extension period each place it appears . (b) Change in timing for report Subsection (e) of such section 410A is amended by striking Not later than 6 months after the completion and inserting Not later than 2 years prior to the completion .

1. Short title This Act may be cited as the Rural Community Hospital Demonstration Extension Act of 2015 . 2. Five-year extension of the Medicare rural community hospital demonstration program (a) Extension Section 410A of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 ( Public Law 108–173 ; 42 U.S.C. 1395ww note), as amended by sections 3123 and 10313 of the Patient Protection and Affordable Care Act ( Public Law 111–148 ), is amended— (1) in subsection (a)(5), by striking 5-year extension period and inserting 10-year extension period ; and (2) in subsection (g)— (A) in the subsection heading, by striking Five-Year and inserting Ten-Year ; (B) in paragraph (1), by striking additional 5-year and inserting additional 10-year ; (C) by striking 5-year extension period and inserting 10-year extension period each place it appears; (D) in paragraph (3), by adding at the end the following new sentence: Notwithstanding the preceding sentence, after the date of the enactment of this sentence, only hospitals described in paragraph (4) or (5) may participate in demonstration program under this section. (E) in paragraph (4)(B)— (i) in the matter preceding clause (i), by inserting each 5-year period in after hospital during ; and (ii) in clause (i), by inserting each applicable 5-year period in after the first day of ; and (F) by adding at the end the following new paragraph: (5) Other hospitals in demonstration program During the second 5 years of the 10-year extension period, the Secretary shall apply the provisions of paragraph (4) to rural community hospitals that are not described in paragraph (4) but are participating in the demonstration program under this section as of December 30, 2014, in a similar manner as such provisions apply to rural community hospitals described in paragraph (4). . (b) Change in timing for report Subsection (e) of such section 410A is amended by striking Not later than 6 months after the completion and inserting Not later than August 1, 2018 .

Amend the title so as to read: A bill to provide for a five-year extension of the Medicare rural community hospital demonstration program. .

July 30, 2015 Reported with an amendment and an amendment to the title