135 STAT. 252  PUBLIC LAW 117–7—APR. 14, 2021  ‘‘(aa) the per visit payment amount applicable  to such rural health clinic for rural health clinic  services furnished in 2020, increased by the  percentage increase in the MEI applicable to pri- mary care services furnished as of the first day  of 2021; or  ‘‘(bb) the limit described in paragraph (2)(A);  and  ‘‘(II) with respect to a rural health clinic that did  not have a per visit payment amount established for  services furnished in 2020—  ‘‘(aa) the per visit payment amount applicable  to such rural health clinic for rural health clinic  services furnished in 2021; or  ‘‘(bb) the limit described in paragraph (2)(A);  and’’; and  (ii) in clause (ii)(I), by striking ‘‘under clause (i)(I)’’  and inserting ‘‘under subclause (I) or (II) of clause  (i), as applicable,’’; and  (B) by striking subparagraph (B) and inserting the  following:  ‘‘(B) A rural health clinic described in this subparagraph is  a rural health clinic that—  ‘‘(i) as of December 31, 2020, was in a hospital with less  than 50 beds and after such date such hospital continues to  have less than 50 beds (not taking into account any increase  in the number of beds pursuant to a waiver under subsection  (b)(1)(A) of section 1135 during the emergency period described  in subsection (g)(1)(B) of such section); and  ‘‘(ii)(I) as of December 31, 2020, was enrolled under section  1866(j) (including temporary enrollment during such emergency  period for such emergency period); or  ‘‘(II) submitted an application for enrollment under section  1866(j) (or a request for such a temporary enrollment for such  emergency period) that was received not later than December  31, 2020.’’.  42 USC 1395 l  note.  42 USC 1396r–4  note.  (2) EFFECTIVE DATE.—The amendments made by this sub- section shall take effect as if included in the enactment of  the Consolidated Appropriations Act, 2021 (Public Law 116–  260).  (b) ADDITIONAL AMOUNT FOR CERTAIN HOSPITALS WITH HIGH  DISPROPORTIONATE SHARE.—Effective as if included in the enact- ment of section 203(a) of title II of division CC of Public Law  116–260, subsection (g) of section 1923 of the Social Security Act  (42 U.S.C. 1396r–4), as amended by such section, is amended by  adding at the end the following:  ‘‘(3) CONTINUED APPLICATION OF GRANDFATHERED TRANSI- TION RULE.—Notwithstanding paragraph (2) of this subsection  (as in effect on October 1, 2021), paragraph (2) of this subsection  (as in effect on September 30, 2021, and as applied under  section 4721(e) of the Balanced Budget Act of 1997, and  amended by section 607 of the Medicare, Medicaid, and SCHIP  Balanced Budget Refinement Act of 1999 (Public Law 106–  113)) shall apply in determining whether a payment adjustment  for a hospital in a State referenced in section 4721(e) of the 