; subsequent redesignation of rural emergency medical center as CAHs Section 1820(c)(2) of the Social Security Act ( 42 U.S.C. 1395i–4(c)(2) ) is amended— (1) in subparagraph (B)(i)(I), by inserting subject to subparagraph (F), before is located ; and (2) by adding at the end the following new subparagraphs: (F) Option to waive distance requirement Beginning on the date of the enactment of this subparagraph, for every critical access hospital located in a State that is certified as a rural emergency medical center under section 1861(jjj)(4), the State shall have the option of waiving the distance requirement described in subparagraph (B)(i)(I) with respect to another facility located in the State that is seeking designation as a critical access hospital under this paragraph. (G) Redesignation of a rural emergency medical center as a critical access hospital A rural emergency medical center that was previously designated as a critical access hospital under this paragraph may elect to be redesignated as a critical access hospital (in the same manner that the hospital was originally designated as a critical access hospital) at any time, subject to such conditions as the Secretary may establish. . (e) Conforming amendment Section 1861(u) of the Social Security Act ( 42 U.S.C. 1395x(u) ) is amended by inserting rural emergency medical center, after critical access hospital, . (f) Effective date The amendments made by this section shall apply to items and services furnished on or after the date that is 1 year after the date of the enactment of this Act.