Five-year extension of the rural community hospital demonstration program

(a)

Extension

(1)

In general

Subsection (a)(5) of section 410A of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (Public Law 108–173; 42 U.S.C. 1395ww note), is amended by striking 10-year extension period and inserting 15-year extension period.(2)

Conforming amendments for extension

(A)

Extension of demonstration period

Subsection (g) of such section 410A is amended—(i)in the subsection heading, by striking

Ten-Year

and inserting

Fifteen-Year

;(ii)in paragraph (1)—(I)by striking additional 10-year and inserting additional 15-year; and(II)by striking 10-year extension period and inserting 15-year extension period;(iii)in paragraph (2), by striking 10-year extension period and inserting 15-year extension period;(iv)in paragraph (3), by striking 10-year extension period and inserting 15-year extension period;(v)in paragraph (4), by striking 10-year extension period each place it appears and inserting 15-year extension period;(vi)in paragraph (5), by striking 10-year extension period and inserting 15-year extension period; and (vii)in subparagraph (A) of paragraph (6), by striking 10-year extension period and inserting 15-year extension period. (B)

Rule for hospitals that are not original participants in the demonstration

Paragraph (5) of subsection (g) of such section 410A is amended—(i)by striking program.—During and inserting

program.—

(A)

CURES Act extension

During

; and

(ii)by adding at the end the following new subparagraph:

(B)

Additional extension

During the third 5 years of the 15-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, 2019, in a similar manner as such provisions apply to rural community hospitals described in paragraph (4).

(C)

Solicitation of applications

Subparagraph (A) of subsection (g)(6) of such section 410A is amended—(i)by striking In general.—The Secretary and inserting

In general.—

(i)

CURES Act solicitation

The Secretary

; and

(ii)by adding at the end the following new clause:

(ii)

Additional solicitation

The Secretary shall, notwithstanding subsection (a)(2) or paragraph (2) of this subsection, not later than 120 days after the date of the enactment of this clause, issue a solicitation for applications to select up to the maximum number of additional rural community hospitals located in any State to participate in the demonstration program under this section for the third 5 years of the 15-year extension period without exceeding the limitation under paragraph (3) of this subsection.

(b)

Clarification of application of case mix adjustment

Subsection (b) of such section 410A is amended by adding at the end the following new paragraph:

(3)

Case mix adjustment

The Secretary shall provide for an appropriate adjustment under this paragraph to take into account variations in case mix of rural community hospitals, using the most recent case-mix data available.

(c)

Change in timing for report

Subsection (e) of such section 410A is amended by striking Not later than August 1, 2018 and inserting Not later than August 1, 2023.(d)

Clarifying technical amendments

Such section 410A, as amended by subsections (a), (b), and (c), is further amended—(1)in subsection (a)(1), by inserting of Health and Human Services after Secretary;(2)in subsection (f)(1)(A)(iv) by inserting of the Social Security Act (42 U.S.C. 1395i–4) after section 1820; and(3)in subsection (g)—(A)in the heading of paragraph (4), by striking

Hospitals in demonstration program on date of enactment

and inserting

Hospitals participating in the demonstration program during the initial 5-year period

; and(B)in clause (i) of paragraph (6)(A), as amended by subsection (a)(2)(C)(i), by striking not later than 120 days after the date of the enactment of this paragraph and inserting not later than April 12, 2017.