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<dc:title>108 S4460 ES: Rural Community Hospital Demonstration Program Reauthorization</dc:title>
<dc:publisher>U.S. Senate</dc:publisher>
<dc:date></dc:date>
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<dc:language>EN</dc:language>
<dc:rights>Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain.</dc:rights>
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<congress display="yes">119th CONGRESS</congress><session display="yes">2d Session</session><legis-num display="yes">S. 4460</legis-num><current-chamber display="no">IN THE SENATE OF THE UNITED STATES</current-chamber><legis-type display="yes">AN ACT</legis-type><official-title display="yes">To provide for an extension of the rural community hospital demonstration program.</official-title></form><legis-body style="OLC" display-enacting-clause="yes-display-enacting-clause"><section id="S1" section-type="section-one" commented="no" display-inline="no-display-inline"><enum>1.</enum><header display-inline="yes-display-inline">Short title</header><text display-inline="no-display-inline">This Act may be cited as the <quote><short-title>Rural Community Hospital Demonstration Program Reauthorization</short-title></quote>.</text></section><section id="H4E6984E215BC4F9AB5A16289F6D4C1CA" commented="no" display-inline="no-display-inline" section-type="subsequent-section"><enum>2.</enum><header display-inline="yes-display-inline">Five-year extension of the rural community hospital demonstration program</header><subsection id="H26BD4C86655B4C99B7215C2CFC2BE87D" commented="no" display-inline="no-display-inline"><enum>(a)</enum><header display-inline="yes-display-inline">In general</header><text display-inline="yes-display-inline">Subsection (a)(5) of section 410A of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (<external-xref legal-doc="public-law" parsable-cite="pl/108/173">Public Law 108–173</external-xref>; <external-xref legal-doc="usc" parsable-cite="usc/42/1395ww">42 U.S.C. 1395ww</external-xref> note), is amended by striking <quote>15-year extension period</quote> and inserting <quote>20-year extension period</quote>.</text></subsection><subsection id="HAFC3D891D1BC4BC382DC0F966500853A" commented="no" display-inline="no-display-inline"><enum>(b)</enum><header display-inline="yes-display-inline">Conforming amendments for extension</header><paragraph id="HB8F6503C951348B9B6F97352C48C4891" commented="no" display-inline="no-display-inline"><enum>(1)</enum><header display-inline="yes-display-inline">Extension of demonstration period</header><text display-inline="yes-display-inline">Subsection (g) of such section 410A is amended—</text><subparagraph id="HAEC776C5B5694616B00BF50B888476B0" commented="no" display-inline="no-display-inline"><enum>(A)</enum><text display-inline="yes-display-inline">in the subsection heading, by striking <quote><header-in-text level="subsection" style="OLC">Fifteen-Year</header-in-text></quote> and inserting <quote><header-in-text level="subsection" style="OLC">Twenty-Year</header-in-text></quote>;</text></subparagraph><subparagraph id="H9F8F0C7F78384049A24A84ECC785AB4D" commented="no" display-inline="no-display-inline"><enum>(B)</enum><text display-inline="yes-display-inline">in paragraph (1)—</text><clause commented="no" id="H59A0B91B391E4A62BB8BF0D8320004FE" display-inline="no-display-inline"><enum>(i)</enum><text display-inline="yes-display-inline">by striking <quote>additional 15-year</quote> and inserting <quote>additional 20-year</quote>; and</text></clause><clause id="H5D93014424CC4D76A019CB71FA0DB8BC" commented="no" display-inline="no-display-inline"><enum>(ii)</enum><text display-inline="yes-display-inline">by striking <quote>15-year extension period</quote> and inserting <quote>20-year extension period</quote>;</text></clause></subparagraph><subparagraph id="HBA9D572725804D5CB0C2D7483AEB2B9E" commented="no" display-inline="no-display-inline"><enum>(C)</enum><text display-inline="yes-display-inline">in paragraph (2), by striking <quote>15-year extension period</quote> and inserting <quote>20-year extension period</quote>;</text></subparagraph><subparagraph id="H7D328F169AB34143B2A0821BB3E3B406" commented="no" display-inline="no-display-inline"><enum>(D)</enum><text display-inline="yes-display-inline">in paragraph (3), by striking <quote>15-year extension period</quote> and inserting <quote>20-year extension period</quote>;</text></subparagraph><subparagraph id="H963CE7921B40450695D116CCB57C62EB" commented="no" display-inline="no-display-inline"><enum>(E)</enum><text display-inline="yes-display-inline">in paragraph (4), by striking <quote>15-year extension period</quote> each place it appears and inserting <quote>20-year extension period</quote>;</text></subparagraph><subparagraph id="HAE50EF79C3E649629309969DA10A2A24" commented="no" display-inline="no-display-inline"><enum>(F)</enum><text display-inline="yes-display-inline">in paragraph (5), by striking <quote>15-year extension period</quote> each place it appears and inserting <quote>20-year extension period</quote>; and</text></subparagraph><subparagraph id="H59F31C9212564795A8DEF2F86A770F0D" commented="no" display-inline="no-display-inline"><enum>(G)</enum><text display-inline="yes-display-inline">in subparagraph (A) of paragraph (6), by striking <quote>15-year extension period</quote> and inserting <quote>20-year extension period</quote>.</text></subparagraph></paragraph><paragraph id="H480C5112C4064EA48EB02C38975ED7DB" commented="no" display-inline="no-display-inline"><enum>(2)</enum><header display-inline="yes-display-inline">Rule for hospitals that are not original participants in the demonstration</header><text display-inline="yes-display-inline">Paragraph (5) of subsection (g) of such section 410A is amended—</text><subparagraph commented="no" display-inline="no-display-inline" id="iddbdca664bc1a49a78e591f6a650086b1"><enum>(A)</enum><text display-inline="yes-display-inline">in subparagraph (B), by striking <quote><header-in-text style="OLC" level="subparagraph">Additional extension</header-in-text></quote> and inserting <quote><header-in-text style="OLC" level="subparagraph">CAA, 2021 extension</header-in-text></quote>; and</text></subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="id2d8f7b199e784ebbbefe810f477fbbcf"><enum>(B)</enum><text display-inline="yes-display-inline">by adding at the end the following new subparagraph:</text><quoted-block style="OLC" id="HD85481BF7DA643B0A35434512D58ED37" display-inline="no-display-inline"><subparagraph id="H4E4CB1F288B0435F8A3CE50588DA32E7" commented="no" display-inline="no-display-inline"><enum>(C)</enum><header display-inline="yes-display-inline">Additional extension</header><text display-inline="yes-display-inline">During the fourth 5 years of the 20-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 at any time during the period beginning on December 30, 2024, and ending on January 1, 2027, in a similar manner as such provisions apply to rural community hospitals described in paragraph (4).</text></subparagraph><after-quoted-block display="yes">.</after-quoted-block></quoted-block></subparagraph></paragraph></subsection></section></legis-body><attestation><attestation-group><attestation-date date="20260520" chamber="Senate">Passed the Senate May 20, 2026.</attestation-date><attestor display="no"></attestor><role>Secretary</role></attestation-group></attestation><endorsement display="yes"></endorsement></bill> 

