124 STAT. 685 PUBLIC LAW 111–148—MAR. 23, 2010 (2) in subsection (d)(3)— (A) in subparagraph (B), by striking ‘‘and’’ at the end; (B) in subparagraph (C), by striking the period at the end and inserting ‘‘; and’’; and (C) by adding at the end the following new subpara- graph: ‘‘(D) the hospital meets the requirements described in subsection (i)(1) not later than 18 months after the date of the enactment of this subparagraph.’’; and (3) by adding at the end the following new subsection: ‘‘(i) REQUIREMENTS FOR HOSPITALS TO QUALIFY FOR RURAL PROVIDER AND HOSPITAL EXCEPTION TO OWNERSHIP OR INVESTMENT PROHIBITION.— ‘‘(1) REQUIREMENTS DESCRIBED.—For purposes of subsection (d)(3)(D), the requirements described in this paragraph for a hospital are as follows: ‘‘(A) PROVIDER AGREEMENT.—The hospital had— ‘‘(i) physician ownership or investment on Feb- ruary 1, 2010; and ‘‘(ii) a provider agreement under section 1866 in effect on such date. ‘‘(B) LIMITATION ON EXPANSION OF FACILITY CAPACITY.— Except as provided in paragraph (3), the number of oper- ating rooms, procedure rooms, and beds for which the hos- pital is licensed at any time on or after the date of the enactment of this subsection is no greater than the number of operating rooms, procedure rooms, and beds for which the hospital is licensed as of such date. ‘‘(C) PREVENTING CONFLICTS OF INTEREST.— ‘‘(i) The hospital submits to the Secretary an annual report containing a detailed description of— ‘‘(I) the identity of each physician owner or investor and any other owners or investors of the hospital; and ‘‘(II) the nature and extent of all ownership and investment interests in the hospital. ‘‘(ii) The hospital has procedures in place to require that any referring physician owner or investor discloses to the patient being referred, by a time that permits the patient to make a meaningful decision regarding the receipt of care, as determined by the Secretary— ‘‘(I) the ownership or investment interest, as applicable, of such referring physician in the hos- pital; and ‘‘(II) if applicable, any such ownership or investment interest of the treating physician. ‘‘(iii) The hospital does not condition any physician ownership or investment interests either directly or indirectly on the physician owner or investor making or influencing referrals to the hospital or otherwise generating business for the hospital. ‘‘(iv) The hospital discloses the fact that the hos- pital is partially owned or invested in by physicians— ‘‘(I) on any public website for the hospital; and ‘‘(II) in any public advertising for the hospital. ‘‘(D) ENSURING BONA FIDE INVESTMENT.— Reports. Deadline.
