Save America’s Rural Hospitals Act

This bill, called the Save America’s Rural Hospitals Act, aims to keep care close to home for people in rural communities. It boosts payments to rural providers under Medicare and Medicaid and cuts red tape, responding to many rural hospital closures and long drives for emergency and basic care.

It would stop automatic Medicare cuts to rural hospitals; restore help for hospitals with unpaid patient bills; and make several payment boosts permanent for small, low‑volume, and Medicare‑dependent rural hospitals. It raises Medicare payments in lower‑wage areas and sets a minimum level for those rates, starting in late 2025 and early 2026. It keeps higher pay for rural ambulance rides and permanently extends telehealth options for community health centers and rural clinics. States could again waive the 35‑mile rule to designate certain small, financially strained hospitals as critical access, within national and state limits, with federal rules due within 120 days. Patient co‑pays at critical access hospitals would be made more consistent. The bill also removes the 4‑day inpatient limit for those hospitals and allows covered extended care at certain hospitals without a prior hospital stay. Finally, it funds grants to help rural providers upgrade technology, train staff, and move to new care models like rural emergency hospitals, expanded telehealth, and added mental health and dental services.

• Who is affected: People in rural areas; Medicare patients; rural hospitals (including critical access, sole community, low‑volume, and Medicare‑dependent hospitals); rural health clinics and community health centers; and rural ambulance services.
• What changes: Higher and more stable Medicare pay; permanent rural telehealth and ambulance payments; fewer limits on rural hospital stays and services; state flexibility to keep key hospitals open; and new grants for upgrades and care transformation.
• When: Many parts take effect about 60 days after it becomes law; payment changes tied to local wages begin October 1, 2025 (inpatient) and January 1, 2026 (outpatient); federal rules for the state waiver program are due within 120 days.