Sponsors (6)
Official title: To amend titles XVIII and XIX of the Social Security Act to provide for enhanced payments to rural health care providers under the Medicare and Medicaid programs, and for other purposes.
Introduced June 3, 2025 by Samuel Graves · Last progress June 3, 2025
The bill directs substantial new and extended Medicare payment supports and multi‑year grants to stabilize and expand rural health care access, at the trade‑off of higher federal spending, administrative complexity, and risks of uneven distribution or reduced cost‑containment incentives.
Rural hospitals and the communities they serve will receive higher and more stable Medicare payments (sequestration exclusion, bad‑debt add‑on, low‑wage adjustment, wage‑index floor and payment-policy extensions), improving short‑term finances and capacity to keep services open.
Medicare beneficiaries in rural areas will have better access to inpatient and extended services (removal of the 96‑hour annual‑average cap, ability to bill under section 1883 agreements) and more reclassification/telehealth/ambulance continuity, helping preserve local care options.
Rural providers will get predictable federal grant support and multi-year Rural Health Transformation Grants plus technical assistance and evaluation to help transition to new care models (e.g., rural emergency hospitals), supporting long‑term service sustainability.
Taxpayers and Medicare finances will face higher federal spending from exclusions, payment increases, expanded inpatient/extended coverage, and new grants, which could raise deficits or require offsets (higher premiums, taxes, or cuts elsewhere).
Making or extending payment increases may blunt incentives for local cost containment and could shift limited Medicare dollars away from non‑rural hospitals via budget‑neutral offsets.
Caps on the number of new state‑certified CAHs (total cap and per‑state limits) could block some struggling hospitals from obtaining CAH status, leaving certain rural communities without preserved services.
Based on analysis of 8 sections of legislative text.
Adjusts Medicare rules to protect and increase payments to rural hospitals, relax certain CAH limits, expand FLEX program authorities, and create a 5-year Rural Health Transformation Grants program.
Makes a set of targeted changes to Medicare rules to strengthen payment and operational support for rural providers. It exempts certain rural hospitals from sequestration, raises allowable bad-debt reimbursement for rural hospitals, extends temporary inpatient payment and rural reclassification provisions beyond FY2025, equalizes outpatient CAH copay treatment, relaxes inpatient length-of-stay and physician-certification rules for critical access hospitals (CAHs), requires coverage of certain non-posthospital extended care services by subsection 1883 hospitals, and creates/expands FLEX program authorities including a new 5-year Rural Health Transformation Grants program and technical-assistance grants.