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The bill makes it easier for hospitals to designate off‑campus sites as provider‑based—helping preserve local hospital services and revenue—but likely raises Medicare costs and patient cost‑sharing and may weaken independent community providers.
Hospitals and health systems can bill more off‑campus outpatient sites as hospital provider‑based locations, increasing revenue for local hospitals and health systems.
Medicare beneficiaries and patients in rural or remote communities may retain or gain local access to hospital‑affiliated services that otherwise might close or move farther away.
Hospitals may be more able to invest in and staff off‑campus sites, supporting workforce stability and continuity of local services.
Medicare program spending is likely to increase because more sites would be paid at higher hospital outpatient rates, raising costs for taxpayers and the program.
Medicare beneficiaries could face higher out‑of‑pocket costs if services shift from independently billed clinics to hospital outpatient billing with higher cost‑sharing.
Independent community providers and small practices may be disadvantaged or acquired as hospitals convert off‑campus sites to provider‑based status, reducing local competition and choice.
Based on analysis of 2 sections of legislative text.
Directs HHS to remove the Medicare 35‑mile limit so off‑campus facilities can qualify for provider‑based status.
Introduced January 28, 2025 by Mark E. Green · Last progress January 28, 2025
Requires the HHS Secretary to revise Medicare rules within 60 days to remove the rule that limits off‑campus facilities to within a 35‑mile radius of a hospital for provider‑based status. The change would let more off‑campus emergency departments and similar facilities qualify as provider‑based, which can change how Medicare pays them and affect patient cost sharing and hospital revenues.