S1390119th CongressWALLET

Physician Led and Rural Access to Quality Care Act

Sponsored By: Senator James Lankford

Introduced

Summary

Creates a new "covered rural hospital" category and changes how physician self-referral rules apply to physician-owned hospitals in rural areas. The bill would let certain rural hospitals that enroll in Medicare (Title XVIII of the Social Security Act) meet a narrow set of criteria that changes which self-referral exemptions apply, and it would lift a ban on certain hospital expansions starting on the date of enactment.

Show full summary
  • Rural hospitals and communities: Hospitals located in rural areas that enroll in Medicare and meet the specified criteria could be designated as "covered rural hospitals," which changes how self-referral exemptions apply to them. This affects which physician-investment arrangements are treated as exempt.
  • Physician-owners and hospital investors: The bill would add a sunset to the expansion prohibition, allowing physician-owned hospitals to expand beginning on the date of enactment for the covered category, subject to the bill's criteria.
  • Medicare program and enrollment rules: The law would amend the Medicare statute to add a definition of "covered rural hospital" and to clarify that meeting the listed criteria does not require meeting other unrelated criteria under section 1820(c)(2)(B).

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Bill Overview

Analyzed Economic Effects

2 provisions identified: 1 benefits, 0 costs, 1 mixed.

Allows physician-owned hospitals to expand

If enacted, the bill would end the statutory ban on expanding physician-owned hospitals starting on the date of enactment. Physician owners would be able to grow or add facilities that were previously restricted. This change could affect investor and hospital expansion plans that interact with Medicare enrollment.

New rules for covered rural hospitals

If enacted, the bill would create a new "covered rural hospital" category for Medicare referral rules. A hospital would be covered if it is in a rural area and met specific enrollment criteria when it joined Medicare. The bill would also remove two existing Medicare self-referral exemptions for those covered rural hospitals. That means some physician-owned rural hospitals would lose those exemptions and face new limits on physician referrals under Medicare.

Sponsors & CoSponsors

Sponsor

James Lankford

OK • R

Cosponsors

  • Roger Marshall

    KS • R

    Sponsored 4/9/2025

  • Bill Cassidy

    LA • R

    Sponsored 4/9/2025

  • Thomas Tillis

    NC • R

    Sponsored 4/9/2025

  • John Cornyn

    TX • R

    Sponsored 4/9/2025

  • Markwayne Mullin

    OK • R

    Sponsored 4/9/2025

  • John Boozman

    AR • R

    Sponsored 4/9/2025

  • John Barrasso

    WY • R

    Sponsored 4/9/2025

  • Ted Budd

    NC • R

    Sponsored 4/9/2025

  • James Justice

    WV • R

    Sponsored 5/14/2025

Roll Call Votes

No roll call votes available for this bill.

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