Sponsors
The bill expands local access and coordination of Medicare services by enabling more off‑campus provider‑based sites, but does so at the cost of higher Medicare spending and patient cost‑sharing, risks of local market consolidation, and a rushed regulatory timeline.
Medicare beneficiaries — especially in rural areas — gain increased local access to care and more coordinated services as hospitals can designate more off‑campus sites as provider‑based.
Hospitals and health systems may receive higher Medicare payments for services at newly provider‑based off‑campus sites, improving revenue stability for providers.
Medicare spending is likely to increase because provider‑based designation typically pays higher rates, raising costs for taxpayers and pressure on the program.
Medicare beneficiaries may face higher out‑of‑pocket cost‑sharing when services are moved to provider‑based sites, increasing patient financial burden.
Hospitals could use provider‑based conversions to consolidate market power — potentially reducing local competition and allowing higher prices in affected communities.
Based on analysis of 2 sections of legislative text.
Removes the Medicare regulation that requires an off‑campus facility to be within 35 miles of a hospital or critical access hospital to qualify for provider‑based status, and directs the Secretary of Health and Human Services to revise the relevant regulation within 60 days after enactment. Also establishes a short title for the Act and contains no other substantive programmatic or funding provisions.
Introduced January 28, 2025 by Mark E. Green · Last progress January 28, 2025