; and (2) by adding at the end the following new subclause: (IV) a hospital that was designated as a comprehensive cancer center by the National Cancer Institute of the National Institutes of Health before the date of the enactment of this subclause, and that is located in a State with less than 35 people per square mile based on 2010 data published by the Bureau of the Census, or . (b) Special Rule for Eligible Hospitals In the case of a hospital described in section 1886(d)(1)(B)(v)(IV) of the Social Security Act, as added by subsection (a), that elects not to be treated as a subsection (d) hospital pursuant to such section (in this section referred to as an eligible hospital ), for purposes of the provisions of section 412.22(e) of title 42, Code of Federal Regulations (or any successor regulations), the eligible hospital shall not be denied an exemption from the prospective payment system under section 1886(d) of the Social Security Act ( 42 U.S.C. 1395ww ) solely because the eligible hospital and another hospital are both under the control of any third entity (including with respect to the governing body, the chief medical officer, or the chief executive officer of the eligible hospital). (c) Effective date The amendments made by subsection (a) shall apply to eligible hospitals in cost reporting periods beginning on or after the date of the enactment of this Act. (d) Budget neutrality The Secretary shall make a proportional adjustment in the standardized amounts otherwise determined under subsection (d)(3) of section 1886 of the Social Security Act ( 42 U.S.C. 1395ww ), for cost reporting periods beginning on or after the date of enactment of this Act, to assure that the provisions of subclause (IV) of subsection (d)(1)(B)(v) of such section, as added by subsection (a), do not result in aggregate payments under such section that are greater or less than those that would otherwise be made if such subclause had not been enacted.