II 115th CONGRESS 1st Session S. 455 IN THE SENATE OF THE UNITED STATES February 27, 2017 Mr. Tester introduced the following bill; which was read twice and referred to the Committee on Finance A BILL To amend title XVIII of the Social Security Act to count resident time spent in a critical access hospital as resident time spent in a nonprovider setting for purposes of making Medicare direct and indirect graduate medical education payments.

1. Short title This Act may be cited as the Restoring Rural Residencies Act of 2017 . 2. Counting resident time spent in a critical access hospital as resident time spent in a nonprovider setting for purposes of making Medicare direct and indirect graduate medical education payments (a) GME Section 1886(h)(4) of the Social Security Act ( 42 U.S.C. 1395ww(h)(4) ) is amended— (1) in subparagraph (E), by striking subparagraphs (J) and (K) and inserting subparagraphs (J), (K), and (L) ; and (2) by adding at the end the following new subparagraph: (L) Treatment of critical access hospitals Effective for cost reporting periods beginning on or after July 1, 2018, such rules shall provide that a critical access hospital (as defined in section 1861(mm)(1)) is deemed to be a nonprovider setting for purposes of determining the hospitals's number of full-time equivalent residents under this subsection. . (b) IME Section 1886(d)(5)(B)(iv)(II) of the Social Security Act ( 42 U.S.C. 1395ww(d)(5)(B)(iv)(II) ) is amended by adding at the end the following sentence: Effective for discharges occurring on or after July 1, 2018, for purposes of this subclause, a critical access hospital (as defined in section 1861(mm)(1)) is deemed to be a nonprovider setting. .