PUBLIC LAW 101-239—DEC. 19, 1989 103 STAT. 2151 . _^ (VII) by adding at the end of paragraph (7) the follow- mg new subparagraph: "(D) A hospital may use a grant received under this subsec- tion to develop a plan for converting itself to a rural primary care hospital (as described in section 1820 of the Social Security Act) or to develop a rural health network (as defined in section 1820(g) of such Act) in the State in which it is located if the State is receiving a grant under section 1820(a)(l).", and (Vin) in paragraph (9), by striking "each of the fiscal years 1989 and 1990" and inserting "fiscal year 1989 and $25,000,000 for each of the fiscal years 1990, 1991, and 1992". (ii) The amendments made by clause (i) shall apply with Effective date, respect to applications for grants under the Rural Health 42 USC 1395ww Care Transition Grant Program described in section 4005(e) ^***®- of the Omnibus Budget Reconciliation Act of 1987 submit- ted on or after October 1, 1989, except that the amendments made by subclauses (V) and (VII) of such clause shall take effect on the date of the enactment of this Act. (2) TREATMENT OF ESSENTIAL ACCESS C!oMMUNiTY HOSPITALS AS SOLE COMMUNITY HOSPITALS.— Section 1886(d)(5)(D) of such Act (42 U.S.C. 1395ww(d)(5)(D)) (as redesignated and amended by subsection (e)(l)(A)) is further amended— (A) in clause (iii)— (i) in subclause (I), by striking "or", (ii) in subclause (II), by striking the period at the end and inserting ", or", and (iii) by adding at the end the following new subclause: "(III) that is designated by the Secretary as an essential access community hospital under section 1820(i)(l).", and (B) by adding at the end the following new clause: "(v) If the Secretary determines that, in the case of a hospital designated by the Secretary as an essential access community hos- pital under section 1820(i)(l), the hospital has incurred increases in - reasonable costs during a cost reporting period as a result of becom- ing a member of a rural health network (as defined in section 1820(g)) in the State in which it is located, and in incurring such increases, the hospital will increase its costs for subsequent cost reporting periods, the Secretary shall increase the hospital's target amount under subsection (b)(3)(C) to account for such incurred increases.". (3) COVERAGE OF, AND PAYMENT FOR, INPATIENT RURAL PRI- MARY CARE HOSPITAL SERVICES. — (A) DEFINITIONS.— Section 1861 of such Act (42 U.S.C. 1395x) is amended by adding at the end the following new subsection: "Rural Primary Care Hospital; Rural Primary Care Hospital Services "(mmXl) The term 'rural primary care hospital' means a facility designated by the Secretary as a rural primary care hospital under section 1820(i)(2). "(2) The term 'inpatient rural primary care hospital services' means items and services, furnished to an inpatient of a rural primary care hospital by such a hospital, that would be inpatient
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