Save America's Rural Hospitals

Full Title:
Save America’s Rural Hospitals Act

Summary#

The Save America’s Rural Hospitals Act would change Medicare and Medicaid rules to give more money and flexibility to many rural hospitals and other rural health providers. Key changes in the bill text include: removing Medicare sequestration for many rural hospitals; increasing reimbursement for hospital bad debt for rural hospitals and critical access hospitals (CAHs); permanently extending higher payments for low-volume and Medicare-dependent hospitals; extending disproportionate share (DSH) payments for some rural hospitals; rebasing target amounts for certain rural hospitals; and adjusting area wage index rules to raise pay factors for low-wage areas and set a minimum for many hospitals.

The bill also makes permanent or extends some payments and telehealth rules for other rural providers, including ground ambulance payment increases and telehealth payment enhancements for federally qualified health centers and rural health clinics. It restores state authority to waive the 35-mile rule for certain CAH designations, changes beneficiary copay rules for CAH outpatient services, removes the 96-hour average inpatient stay limit for CAHs, allows certain extended care services without a prior hospitalization, and creates or expands grant programs to help rural providers transition to new care models (for example, rural emergency hospitals, extended stay clinics, and telehealth services).

Many sections in the bill set specific effective dates, such as provisions that apply 60 days after enactment or on October 1, 2025, and require the Secretary of Health and Human Services to issue rules or regulations to implement some changes.

What it means for you#

  • If you live in a rural area, hospitals and clinics near you could receive higher Medicare or Medicaid payments and more flexibility. That could help keep local emergency rooms, outpatient services, and other care open.
  • Federally qualified health centers and rural health clinics could keep telehealth payment rules that were set during the emergency period.
  • Ambulance services in rural areas would receive permanently increased Medicare payments under the bill text.
  • Some hospitals could change how they operate (for example converting to rural emergency hospitals) with grant support to help transitions.

Expenses#

The bill changes payment formulas and creates grant programs, but the text does not provide dollar amounts or score estimates. No publicly available information.

Proponents' View#

The bill text lists reasons supporters give for these changes: many Americans in rural areas depend on local hospitals and providers; rural residents are often older, poorer, and sicker than urban residents; hundreds of rural hospitals have closed and many more are at risk; and travel distance, workforce shortages, and financial pressure reduce access to emergency and other care. Supporters argue increased payments, regulatory relief, and grants will stabilize rural providers and preserve access.

Opponents' View#

No publicly available information.