12 2 STA T . 2 5 1 4PUBLIC LA W 11 0– 2 7 5 —J UL Y 15 , 200 8formaking gran tsu n de rt h is p aragraph ,$5 , 0 00,000 for fis c a ly ear 2 00 8.‘ ‘ (F)ELIG I B L ECR I T IC A L ACCE S S HO S P ITAL D E F I N ED. — For purposes of this paragraph, the term ‘eligi b le critical access hospital ’ means a critical access hospital that has ana v erage daily acute census of less than 0.5 and an average daily s w ing bed census of greater than 1 0.0.’’. SEC.12 2. R E BA S INGFO RSO L ECO M M U NI TYH OS P ITALS. (a) R EBASING P ER M ITTED.— S ection 188 6 (b)( 3 ) of the Social Security A ct( 4 2 U .S. C . 13 9 5ww(b)(3)) is amended by adding at the end the following new subparagraph
‘‘( L )(i) For cost reporting periods beginning on or after J anuary 1, 2009, in the case of a sole community hospital there shall be substituted for the amount otherwise determined under subsection (d)(5)( D )(i) of this section, if such substitution results in a greater amount of payment under this section for the hospital, the subpara - graph (L) rebased target amount. ‘‘(ii) For purposes of this subparagraph, the term ‘subparagraph (L) rebased target amount’ has the meaning given the term ‘target amount’ in subparagraph (C), e x cept that— ‘‘( I ) there shall be substituted for the base cost reporting period the 12-month cost reporting period beginning during fiscal year 2006
‘‘(II) any reference in subparagraph (C)(i) to the ‘first cost reporting period’ described in such subparagraph is deemed a reference to the first cost reporting period beginning on or after January 1, 2009; and ‘‘(III) the applicable percentage increase shall only be applied under subparagraph (C)(iv) for discharges occurring on or after January 1, 2009.’’. (b) CONFORMING AMENDMENTS.—Section 1886(b)(3) of the Social Security Act (42 U.S.C. 1395ww(b)(3)) is amended— (1) in subparagraph (C), in the matter preceding clause (i), by striking ‘‘subparagraph (I)’’ and inserting ‘‘subparagraphs (I) and (L)’’; and (2) in subparagraph (I)(i), in the matter preceding subclause (I), by striking ‘‘For’’ and inserting ‘‘Sub j ect to subparagraph (L), for’’. SEC. 12 3 . D EMONSTRATION PRO J ECT ON COMMUNITY HEALTH INTEGRATION MODELS IN CERTAIN RURAL COUNTIES. (a) IN G ENERAL.— T he Secretary shall establish a demonstration project to allow eligible entities to develop and test new models for the delivery of health care services in eligible counties for the purpose of improving access to, and better integrating the delivery of, acute care, extended care, and other essential health care services to M edicare beneficiaries. (b) P U RPOSE.—The purpose of the demonstration project under this section is to— (1) explore ways to increase access to, and improve the ade q uacy of, payments for acute care, extended care, and other essential health care services provided under the Medicare and Medicaid programs in eligible counties; and (2) evaluate regulatory challenges facing such providers and the communities they serve. (c) RE Q UIREMENTS.—The following requirements shall apply under the demonstration project: 42USC1395i– 4 note.Ap p l i cab ilit y .
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