; and (2) the Secretary should take into account only the timeliness of such a report made with respect to such a period when determining whether to suspend payments to a supplier under section 1834(l) of the Social Security Act ( 42 U.S.C. 1395m(l) ). 204. Ground ambulance services cost reporting study (a) In general Not later than March 15, 2023, and as determined necessary by the Medicare Payment Advisory Commission thereafter, such Commission shall assess and submit to Congress a report on cost reports carried out in accordance with sections 1121(a) and 1834(l) of the Social Security Act ( 42 U.S.C. 1320a(a) , 1395m(l)), the adequacy of payments for such services made under section 1834(l) of such Act, and geographic variations in the cost of providing such services. (b) Contents The report described in subsection (a) shall contain the following: (1) An analysis of cost report data submitted in accordance with such sections. (2) An analysis of any burden on providers and suppliers of such services associated with reporting such data. (3) A recommendation on whether or not cost reports of ambulance services made by suppliers or a category of suppliers (as specified by the Secretary) of such services, or the ground ambulance portion of cost reports made by providers of such services, should be required or modified, taking into account the analyses described in paragraphs (1) and (2). 205. Extension of ground ambulance services extenders Section 1834(l) of the Social Security Act ( 42 U.S.C. 1395m(l) ) is amended— (1) in paragraph (12)(A), by striking 2018 and inserting 2023 ; and (2) in paragraph (13)(A), by striking 2018 each place it appears and inserting 2023 . 206. Extension of increased inpatient hospital payment adjustment for certain low-volume hospitals Section 1886(d)(12) of the Social Security Act ( 42 U.S.C. 1395ww(d)(12) ) is amended— (1) in subparagraph (B), in the matter preceding clause (i), by striking and for discharges occurring in fiscal year 2020 and subsequent fiscal years