during the time the interns or residents spend in that rural hospital in accordance with subclause (II). In this subclause, the term rural hospital means a hospital that is located in a rural area (as defined for purposes of paragraph (2)(D)). . (b) Direct medical education Section 1886(h)(4)(E) of the Social Security Act ( 42 U.S.C. 1395(h)(4)(E) ) is amended— (1) in clause (ii), by striking the period at the end and inserting