; (2) in subparagraph (C)(i)— (A) by striking fiscal years 2011 through 2017 each place it appears and inserting fiscal years 2011 through 2019 ; and (B) by striking or portion of fiscal year ; and (3) in subparagraph (D)— (A) in the heading, by striking Temporary applicable percentage increase and inserting Applicable percentage increase beginning with fiscal year 2011 ; (B) by striking fiscal years 2011 through 2017, and inserting fiscal years 2011 through 2019 ; and (C) by striking or the portion of fiscal year each place it appears. 207. Extension of the Medicare-Dependent Hospital (MDH) program (a) In general Section 1886(d)(5)(G) of the Social Security Act ( 42 U.S.C. 1395ww(d)(5)(G) ) is amended— (1) in clause (i), by striking October 1, 2017 and inserting October 1, 2019 ; and (2) in clause (ii)(II), by striking October 1, 2017 and inserting October 1, 2019 . (b) Conforming Amendments (1) Extension of target amount Section 1886(b)(3)(D) of the Social Security Act ( 42 U.S.C. 1395ww(b)(3)(D) ) is amended— (A) in the matter preceding clause (i), by striking October 1, 2017 and inserting October 1, 2019 ; and (B) in clause (iv), by striking through fiscal year 2017 and inserting through fiscal year 2019 . (2) Permitting hospitals to decline reclassification Section 13501(e)(2) of the Omnibus Budget Reconciliation Act of 1993 ( 42 U.S.C. 1395ww note) is amended by striking through fiscal year 2017 and inserting through fiscal year 2019 . 208. Specialized Medicare Advantage plans for special needs individuals (a) Permanent extension Section 1859(f)(1) of the Social Security Act ( 42 U.S.C. 1395w–28(f)(1) ) is amended by striking and for periods before January 1, 2019 . (b) Increased integration of dual SNPs (1) In general Section 1859(f) of the Social Security Act ( 42 U.S.C. 1395w–28(f) ) is amended— (A) in paragraph (3), by adding at the end the following new subparagraph: (F) The plan meets the requirements applicable under paragraph (8).