Sponsors (4)
The bill directs meaningful new funding and support to modernize rural health care and expand behavioral-health and emergency services, but centralizes grant control with State Offices and adds administrative requirements that may disadvantage smaller providers and raise ongoing costs.
Rural hospitals, clinics, and patients: increased federal funding and technical assistance to help rural hospitals transition to rural emergency hospitals and expand behavioral health and substance-use services, improving care access and emergency preparedness in rural communities.
Eligible rural providers (CAHs, RHCs, rural nursing homes, SNFs, emergency providers): access to 5-year transformation grants to modernize services, upgrade IT, fund workforce training, and implement delivery reforms that can improve quality and sustainability of rural care.
State Offices of Rural Health and applicants: a more transparent, proportional allocation formula ties State Office grant amounts to the number of eligible small rural hospitals, improving predictability in how federal funds are distributed across states.
Smaller and resource-poor rural providers (small critical access hospitals, rural nursing homes): may struggle to meet application, coordination, and participation requirements, limiting their ability to access transformation grants and benefit from the program.
Eligible applicants and State Offices: requirement to secure letters of support from Medicaid agencies and private insurers may delay applications, create administrative barriers, or exclude otherwise eligible providers.
Hospitals, clinics, and rural communities: shifting grant recipients from individual hospitals to State Offices of Rural Health could concentrate control at the state level and slow or redirect direct funding to specific hospitals or clinics.
Based on analysis of 2 sections of legislative text.
Expands and restructures a rural hospital program to give State Offices of Rural Health new grant authority, create five-year transformation grants, and fund technical assistance and IT/training for rural providers.
Official title: To amend title XVIII of the Social Security Act to strengthen Medicare rural hospital flexibility program grants.
Introduced December 17, 2025 by Carol Devine Miller · Last progress December 17, 2025
Expands and updates an existing Rural Hospital program in the Social Security Act to give State Offices of Rural Health more flexible grant authority and new transformation and technical assistance grant programs. It widens eligible activities to support rural emergency hospitals, behavioral health and substance-use services during public health emergencies, allows State Offices of Rural Health (not just hospitals) to receive grants, and creates five-year Rural Health Transformation awards plus technical assistance grants for entities helping hospitals pursue or hold rural emergency hospital designation. The changes revise eligibility and application rules, permit use of funds for IT, training, and delivery system reforms, and authorize grants/cooperative agreements for data analysis, evaluation, and technical assistance to improve rural provider capacity and emergency response.