Rural Hospital Support Act
Sponsored By: Senator Grassley, Chuck [R-IA]
Introduced
Summary
Rebasing and permanent extensions of Medicare payments for rural hospitals. This bill would let certain rural hospitals use FY2016 cost data to reset their Medicare inpatient payment targets when that raises their payments, and it would extend key Medicare payment programs for rural providers.
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- Sole Community Hospitals would be allowed to substitute a rebased target amount using the 12‑month cost reporting period beginning in FY2016 for discharges on or after October 1, 2025. If that rebased target yields higher payments then the hospital may receive the larger amount.
- Medicare‑Dependent Hospitals would be able to rebase their target amounts to FY2016 data for discharges on or after October 1, 2025 and the MDH payment method would be made permanent rather than expiring March 31, 2025. The bill would also let hospitals decline reclassification under the MDH program and would limit the Secretary’s authority to lower rebased MDH targets in the rebasing context.
- Low‑Volume Hospitals would see their payment increases extended and regularized into a continuous framework for fiscal years after 2010. The bill would also bar certain adjustments to rebased target amounts for earlier periods before October 1, 2015.
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Bill Overview
Analyzed Economic Effects
2 provisions identified: 2 benefits, 0 costs, 0 mixed.
Higher Medicare pay for rural hospitals
If enacted, some rural hospitals could use a rebased payment target tied to the 12‑month cost period starting in fiscal year 2016. This rebasing would apply for cost reporting periods or discharges on or after October 1, 2025, and only if it raises the hospital's Medicare payment. The bill would also remove the April 1, 2025 cutoff so Medicare‑dependent hospital rules continue after that date and would let hospitals decline reclassification for later years. HHS would be barred from making certain retroactive adjustments to those rebased amounts dated before October 1, 2015.
Keep higher pay for low-volume hospitals
If enacted, low‑volume hospitals would keep their higher Medicare payment percentages beyond prior year cutoffs. The bill would make those increases apply from fiscal year 2011 and each year after, and from fiscal year 2019 and each year after.
Sponsors & CoSponsors
Sponsor
Grassley, Chuck [R-IA]
IA • R
Cosponsors
Peter Welch
VT • D
Sponsored 1/30/2025
Shelley Capito
WV • R
Sponsored 1/30/2025
Sen. Kaine, Tim [D-VA]
VA • D
Sponsored 1/30/2025
Roger Wicker
MS • R
Sponsored 1/30/2025
Sen. Shaheen, Jeanne [D-NH]
NH • D
Sponsored 1/30/2025
Sen. Moran, Jerry [R-KS]
KS • R
Sponsored 1/30/2025
Sen. Smith, Tina [D-MN]
MN • D
Sponsored 1/30/2025
Cindy Hyde-Smith
MS • R
Sponsored 1/30/2025
Sen. Fetterman, John [D-PA]
PA • D
Sponsored 1/30/2025
John Boozman
AR • R
Sponsored 1/30/2025
Sen. Kelly, Mark [D-AZ]
AZ • D
Sponsored 1/30/2025
Sen. Marshall, Roger [R-KS]
KS • R
Sponsored 2/3/2025
Gary Peters
MI • D
Sponsored 2/3/2025
Sen. Kennedy, John [R-LA]
LA • R
Sponsored 3/5/2025
Sen. Budd, Ted [R-NC]
NC • R
Sponsored 7/16/2025
Sen. Warner, Mark R. [D-VA]
VA • D
Sponsored 7/16/2025
Roll Call Votes
No roll call votes available for this bill.
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