date The amendments made by this section shall take effect on the date of the enactment of this Act. 3. Removing outdated laboratory requirements (a) In general Section 1861(aa)(2)(G) of the Social Security Act ( 42 U.S.C. 1395x(aa)(2)(G) ) is amended by striking , including clinical laboratory services and all that follows through additional diagnostic services and inserting the following: and has prompt access to clinical laboratory services and additional diagnostic services . (b) Effective date The amendments made by this section shall take effect on the date of the enactment of this Act. 4. Allowing rural health clinics the flexibility to contract with physician assistants and nurse practitioners (a) In general Section 1861(aa) of the Social Security Act ( 42 U.S.C. 1395x(aa) ), in the first sentence of the flush matter following paragraph (2), is amended by striking (iii) employs a physician assistant or nurse practitioner, and (iv) and inserting and (iii) . (b) Effective date The amendment made by subsection (a) shall take effect on the date of the enactment of this Act. 5. Allowing rural health clinics to be the distant site for a telehealth visit (a) In general Section 1834(m) of the Social Security Act ( 42 U.S.C. 1395m(m) ) is amended— (1) in the first sentence of paragraph (1)— (A) by striking or a practitioner (described in section 1842(b)(18)(C)) and inserting , a practitioner (described in section 1842(b)(18)(C)), or a rural health clinic