PUBLIC LAW 106-554—APPENDIX F 114 STAT. 2763A-483 "(B) by an entity that is owned and operated by a critical access hospital, but only if the critical access hospital or entity is the only provider or supplier of ambulance services that is located within a 35-mile drive of such critical access hospital.". (b) CONFORMING AMENDMENT. —Section 1833(a)(l)(R) (42 U.S.C. 13951(a)(l)(R)) is amended— (1) by striking "ambulance service," and inserting "ambulance services, (i)"; and (2) by inserting before the comma at the end the following: "and (ii) with respect to ambulance services described in section 1834(1)(8), the amounts paid shall be the amounts determined under section 1834(g) for outpatient critical access hospital services". (c) EFFECTIVE DATE. —The amendments made by this section shall apply to services furnished on or after the date of the enactment of this Act. SEC. 206. GAG STUDY ON CERTAIN ELIGIBILITY REQUIREMENTS FOR CRITICAL ACCESS HOSPITALS. (a) STUDY. — The Comptroller General of the United States shall conduct a study on the eligibility requirements for critical access hospitals under section 1820(c) of the Social Security Act (42 U.S.C. 1395i-4(c)) with respect to limitations on average length of stay and number of beds in such a hospital, including an analysis of— (1) the feasibility of having a distinct part unit as part of a critical access hospital for purposes of the medicare program under title XVIII of such Act; and (2) the effect of seasonal variations in patient admissions on critical access hospital eligibility requirements with respect to limitations on average annual length of stay and number of beds. (b) REPORT.— Not later than 1 year after the date of the enactment of this Act, the Comptroller General shall submit to Congress a report on the study conducted under subsection (a) together with recommendations regarding— (1) whether distinct part units should be permitted as part of a critical access hospital under the medicare program; (2) if so permitted, the payment methodologies that should apply with respect to services provided by such units; (3) whether, and to what extent, such units should be included in or excluded from the bed limits applicable to critical access hospitals under the medicare program; and (4) any adjustments to such eligibility requirements to account for seasonal variations in patient admissions. Subtitle B—Other Rural Hospitals Provisions SEC. 211. TREATMENT OF RURAL DISPROPORTIONATE SHARE HOS- PITALS. (a) APPLICATION OF UNIFORM THRESHOLD.— Section 1886(d)(5)(F)(v) (42 U.S.C. 1395ww(d)(5)(F)(v)) is amended— (1) in subclause (II), by inserting "(or 15 percent, for discharges occurring on or after April 1, 2001)" after "30 percent";
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