The American Recovery and Reinvestment Act (ARRA), enacted on February 17, 2009, expands the exceptions to the three-year moratorium on LTCH or LTCH satellites previously enacted in the Medicare, Medicaid, and SCHIP Extension Act (MMSEA) (Pub. L. 110-173). The new exception permits an increase in the number of beds in an existing LTCH or LTCH satellite when the bed increase was authorized under a Certificate of Need (CON) issued within a specified timeframe. CMS is amending the guidance issued in S&C-08-26 to reflect this statutory change. CMS Regional Offices will determine whether a facility qualifies for the new exception to the moratorium.