H.R. 4250
119th CONGRESS 1st Session
To amend title XVIII of the Social Security Act to establish a floor on payments to sole community hospitals located in Alaska and Hawaii under the hospital outpatient prospective payment system.
IN THE HOUSE OF REPRESENTATIVES · June 30, 2025 · Sponsor: Mr. Begich
Table of contents
SEC. 1. Short title
- This Act may be cited as the or the .
SEC. 2. Treatment of sole community hospitals located in Alaska and Hawaii under hospital outpatient prospective payment system
- Section 1833(t) of the Social Security Act () is amended by adding at the end the following new paragraph: 42 U.S.C. 1395l(t)
- (23) Treatment of sole community hospitals located in Alaska and Hawaii
- (A) In general
- If the Secretary determines that the amount of payment under this subsection for covered OPD services furnished by a sole community hospital (as defined in section 1886(d)(5)(D)(iii)) that is located in Alaska or Hawaii is less than 94 percent of the reasonable costs (as defined in section 1861(v)) of the hospital providing such services, the amount of payment under this subsection shall be increased by the amount of such difference.
- (B) No effect on copayments
- Nothing in this paragraph shall be construed to affect the copayment amount under paragraph (8).
- (C) Application without regard to budget neutrality
- The additional payments made under this paragraph—
- (i) shall not be considered an adjustment under paragraph (2)(E); and
- (ii) shall not be implemented in a budget neutral manner.
- The additional payments made under this paragraph—
- (D) Rulemaking
- Not later than 6 months after the date of enactment of this paragraph, the Secretary shall promulgate regulations to carry out this paragraph, which shall be effective with respect to covered OPD services furnished on or after the first January 1 after such date.
- (A) In general
- (23) Treatment of sole community hospitals located in Alaska and Hawaii