42 U.S.C. 1395i-4: Medicare rural hospital flexibility program

2010

• Pub. L. 111–148, §3129(b)(1), inserted "and to assist such hospitals in participating in delivery system reforms under the provisions of and amendments made by the Patient Protection and Affordable Care Act, such as value-based purchasing programs, accountable care organizations … (Patient Protection and Affordable Care Act) Law text · (g)
• Pub. L. 111–148, §3129(b)(2), substituted ", to offset" for ", and to offset" and inserted "and to participate in delivery system reforms under the provisions of and amendments made by the Patient Protection and Affordable Care Act, such as value-based purchasing programs, accoun… (Patient Protection and Affordable Care Act) Law text · (g)
• Pub. L. 111–148, §3129(a), substituted "2010, for" for "2010, and for" and inserted "and for making grants to all States under subsection (g), such sums as may be necessary in each of fiscal years 2011 and 2012, to remain available until expended" before period at end. (Patient Protection and Affordable Care Act) Law text · (j)

2008

• Pub. L. 110–275, §121(d), added subpar. (D). (Medicare Improvements for Patients and Providers Act of 2008) Law text · (g)
• Pub. L. 110–275, §121(b)(2), which directed insertion of "and, of the total amount appropriated for grants under paragraphs (1), (2), and (6) for a fiscal year (beginning with fiscal year 2009)" after "2005)", was executed by making the insertion after "2008)" to reflect the probabl… (Medicare Improvements for Patients and Providers Act of 2008) Law text · (g)
• Pub. L. 110–275, §121(b)(1), substituted "for each of fiscal years 2005 through 2008" for "beginning with fiscal year 2005". (Medicare Improvements for Patients and Providers Act of 2008) Law text · (g)
• Pub. L. 110–275, §121(a), added par. (6). (Medicare Improvements for Patients and Providers Act of 2008) Law text · (g)
• Pub. L. 110–275, §121(e), added par. (7). (Medicare Improvements for Patients and Providers Act of 2008) Law text · (g)
• Pub. L. 110–275, §121(c), substituted "2002, for" for "2002, and for" and inserted ", for making grants to all States under paragraphs (1) and (2) of subsection (g), $55,000,000 in each of fiscal years 2009 and 2010, and for making grants to all States under paragraph (6) of subsection… (Medicare Improvements for Patients and Providers Act of 2008) Law text · (j)

2003

• Pub. L. 108–173, §405(h)(1), inserted "before January 1, 2006," after "is certified". (Medicare Prescription Drug, Improvement, and Modernization Act of 2003) Law text · (c)
• Pub. L. 108–173, §405(e)(1), substituted "25" for "15 (or, in the case of a facility under an agreement described in subsection (f) of this section, 25)". (Medicare Prescription Drug, Improvement, and Modernization Act of 2003) Law text · (c)
• Pub. L. 108–173, §405(g)(1), added subpar. (E). (Medicare Prescription Drug, Improvement, and Modernization Act of 2003) Law text · (c)
• Pub. L. 108–173, §405(e)(2), struck out "and the number of beds used at any time for acute care inpatient services does not exceed 15 beds" after "does not exceed 25 beds". (Medicare Prescription Drug, Improvement, and Modernization Act of 2003) Law text · (f)
• Pub. L. 108–173, §405(f)(2), added pars. (4) and (5). (Medicare Prescription Drug, Improvement, and Modernization Act of 2003) Law text · (g), (5)
• Pub. L. 108–173, §405(h)(2)(A), substituted "provisions" for "of certain facilities" in heading. (Medicare Prescription Drug, Improvement, and Modernization Act of 2003) Law text · (h)
• Pub. L. 108–173, §405(h)(2)(B), added par. (3). (Medicare Prescription Drug, Improvement, and Modernization Act of 2003) Law text · (h)
• Pub. L. 108–173, §101(e)(1), substituted "part E" for "part D". (Medicare Prescription Drug, Improvement, and Modernization Act of 2003) Law text · (i)
• Pub. L. 108–173, §405(f)(1), inserted before period at end ", and for making grants to all States under paragraphs (1) and (2) of subsection (g), $35,000,000 in each of fiscal years 2005 through 2008". (Medicare Prescription Drug, Improvement, and Modernization Act of 2003) Law text · (j)

1999

• Pub. L. 106–113, §1000(a)(6) [title IV, §403(c)(1)], substituted "subparagraphs (B), (C), and (D)" for "subparagraph (B)". (Departments of Commerce, Justice, and State, the Judiciary, and Related Agencies Appropriations Act, 2000) Law text · (c)
• Pub. L. 106–113, §1000(a)(6) [title IV, §403(b)], substituted "hospital" for "nonprofit or public hospital". (Departments of Commerce, Justice, and State, the Judiciary, and Related Agencies Appropriations Act, 2000) Law text · (c)
• Pub. L. 106–113, §1000(a)(6) [title IV, §401(b)(2)], inserted "or is treated as being located in a rural area pursuant to section 1395ww(d)(8)(E) of this title" after "section 1395ww(d)(2)(D) of this title)". (Departments of Commerce, Justice, and State, the Judiciary, and Related Agencies Appropriations Act, 2000) Law text · (c)
• Pub. L. 106–113, §1000(a)(6) [title III, §321(a)], substituted "that is located in a county (or equivalent unit of local government) in a rural area (as defined in section 1395ww(d)(2)(D) of this title), and that" for "and is located in a county (or equivalent unit of local government) in a rural a… (Departments of Commerce, Justice, and State, the Judiciary, and Related Agencies Appropriations Act, 2000) Law text · (c)
• Pub. L. 106–113, §1000(a)(6) [title IV, §403(a)(1)], substituted "for a period that does not exceed, as determined on an annual, average basis, 96 hours per patient;" for "for a period not to exceed 96 hours (unless a longer period is required because transfer to a hospital … (Departments of Commerce, Justice, and State, the Judiciary, and Related Agencies Appropriations Act, 2000) Law text · (c)
• Pub. L. 106–113, §1000(a)(6) [title IV, §403(c)(2)], added subpars. (C) and (D). (Departments of Commerce, Justice, and State, the Judiciary, and Related Agencies Appropriations Act, 2000) Law text · (c), (D)
• Pub. L. 106–113, §1000(a)(6) [title IV, §409], added par. (3). (Departments of Commerce, Justice, and State, the Judiciary, and Related Agencies Appropriations Act, 2000) Law text · (g)

1997

• Pub. L. 105–33, §4201(a), amended section catchline and text generally, substituting provisions relating to medicare rural hospital flexibility program for provisions relating to essential access community hospital program. (Balanced Budget Act of 1997) Law text
• Pub. L. 105–33, §4002(f)(1), substituted "part D" for "part C". (Balanced Budget Act of 1997) Law text · (j)

1994

• Pub. L. 103–432, §102(b)(2)(B)(i), substituted "paragraph (3) or subsection (k) of this section" for "paragraph (3)". · (c)
• Pub. L. 103–432, §102(b)(1)(A)(i), redesignated par. (2) as (1) and struck out former par. (1) which read as follows: "is located in a rural area (as defined in section 1395ww(d)(2)(D) of this title);". · (e)
• Pub. L. 103–432, §102(b)(1)(A)(ii), substituted "except in the case of a hospital located in an urban area, is located" for "is located" in introductory provisions, substituted "or (ii)" for ", (ii)", and struck out "or (iii) is located in an urban area that meets the criteria fo… · (e)
• Pub. L. 103–432, §102(b)(1)(A)(i), redesignated pars. (2) to (6) as (1) to (5), respectively. · (e)
• Pub. L. 103–432, §102(a)(1), amended subpar. (F) generally. Prior to amendment, subpar. (F) read as follows: "provides not more than 6 inpatient beds (meeting such conditions as the Secretary may establish) for providing inpatient care for a period not to exceed 72 hours (unless … · (f)
• Pub. L. 103–432, §102(f), inserted before period at end ", except that in determining whether a facility meets the requirements of this subparagraph, subparagraphs (E) and (F) of that paragraph shall be applied as if any reference to a 'physician' is a reference to a physician as… · (f)
• Pub. L. 103–432, §102(c), substituted "because, at the time the facility applies to the State for designation as a rural primary care hospital, there is in effect an agreement between the facility and the Secretary under section 1395tt of this title under which the facility's inpati… · (f)
• Pub. L. 103–432, §102(a)(2), added par. (4). · (f)
• Pub. L. 103–432, §102(b)(2)(B)(ii), in cl. (i) inserted "(except as provided in subsection (k) of this section)" and in cl. (ii) inserted "or subsection (k) of this section". · (i)
• Pub. L. 103–432, §102(b)(1)(A)(iii), substituted "paragraph (2)" for "paragraph (3)". · (i)
• Pub. L. 103–432, §102(b)(2)(B)(ii), in cl. (i) inserted "(except as provided in subsection (k) of this section)" and in cl. (ii) inserted "or subsection (k) of this section". · (i)
• Pub. L. 103–432, §102(b)(2)(A)(ii), added subsec. (k). Former subsec. (k) redesignated (l). · (k)
• Pub. L. 103–432, §102(h), substituted "1990 through 1997" for "1990, 1991, and 1992" in introductory provisions. · (l)
• Pub. L. 103–432, §102(b)(2)(A)(i), redesignated subsec. (k) as (l). · (l)

1990

• Pub. L. 101–508, §4008(m)(2)(B)(i), struck out "demonstration" before "program". · (d)
• Pub. L. 101–508, §4008(d)(3), inserted before semicolon at end ", or is located in a county whose geographic area is substantially larger than the average geographic area for urban counties in the United States and whose hospital service area is characteristic of service areas of… · (f)
• Pub. L. 101–508, §4008(d)(2), which directed the substitution of "is a hospital (or, in the case of a facility that closed during the 12-month period that ends on the date the facility applies for such designation, at the time the facility closed)," for "is a hospital," was execu… · (f)
• Pub. L. 101–508, §4008(m)(2)(B)(ii), substituted "regional referral center" for "rural referral center". · (g)
• Pub. L. 101–508, §4008(d)(1), inserted at end "In designating facilities as rural primary care hospitals under this subparagraph, the Secretary shall give preference to facilities not meeting the requirements of clause (i) of subparagraph (A) that have entered into an agreement d… · (i)
• Pub. L. 101–508, §4008(m)(2)(B)(iii), inserted "and part C of this subchapter" after "this part". · (j)