H.R. 1805

119 HR 1805 IH: Assistance for Rural Community Hospitals Act
 U.S. House of Representatives
 2025-03-03
 text/xml
 EN
 Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain.
 I  119th CONGRESS  1st Session  H. R. 1805  IN THE HOUSE OF REPRESENTATIVES   March 3, 2025   Mrs. Miller of West Virginia  (for herself and  Ms. Sewell ) introduced the following bill; which was referred to the  Committee on Ways and Means    A BILL
To amend title XVIII of the Social Security Act to extend Medicare-dependent hospital and Medicare low-volume hospital payments, and to direct the Comptroller General of the United States to carry out a report on Medicare rural hospital classifications.
1.
Short title
This Act may be cited as the   Assistance for Rural Community Hospitals Act   or the   ARCH Act  .
2.
Extending Medicare-dependent hospital and Medicare low-volume hospital payments
(a)
MDH extension
(1)
Extension of payment methodology
Section 1886(d)(5)(G) of the Social Security Act ( 42 U.S.C. 1395ww(d)(5)(G) ) is amended—
(A)
in clause (i), by striking  April 1, 2025  and inserting  October 1, 2031 ; and
(B)
in clause (ii)(II), by striking  April 1, 2025  and inserting  October 1, 2031 .
(2)
Conforming amendments
(A)
Extension of target amount
Section 1886(b)(3)(D) of the Social Security Act ( 42 U.S.C. 1395ww(b)(3)(D) ) is amended—
(i)
in the matter preceding clause (i), by striking  April 1, 2025  and inserting  October 1, 2031  ; and
(ii)
in clause (iv), by striking  fiscal year 2024 and the portion of fiscal year 2025 beginning on October 1, 2024, and ending on March 31, 2025  and inserting  fiscal year 2031 .
(B)
Permitting hospitals to decline reclassification
Section 13501(e)(2) of the Omnibus Budget Reconciliation Act of 1993 ( 42 U.S.C. 1395ww  note) is amended by striking  fiscal year 2024, or the portion of fiscal year 2025 beginning on October 1, 2024, and ending on March 31, 2025  and inserting  fiscal year 2031 .
(b)
LVH extension
Section 1886(d)(12) of the Social Security Act ( 42 U.S.C. 1395ww(d)(12) ) is amended—
(1)
in subparagraph (C)(i)—
(A)
in the matter preceding subclause (I), by striking  through 2024 and the portion of fiscal year 2025 beginning on October 1, 2024, and ending on March 31, 2025  and inserting  through 2031 ;
(B)
in subclause (III), by striking  through 2024 and the portion of fiscal year 2025 beginning on October 1, 2024, and ending on March 31, 2025  and inserting  through 2031 ; and
(C)
in subclause (IV), by striking  the portion of fiscal year 2025 beginning on April 1, 2025, and ending on September 30, 2025, and fiscal year 2026  and inserting  fiscal year 2032 ; and
(2)
in subparagraph (D)—
(A)
in the matter preceding clause (i), by striking  through 2024 or during the portion of fiscal year 2025 beginning on October 1, 2024, and ending on March 31, 2025  and inserting  through 2031 ; and
(B)
in clause (ii), by striking  through 2024 and the portion of fiscal year 2025 beginning on October 1, 2024, and ending on March 31, 2025  and inserting  through 2031 .
3.
GAO report on Medicare rural hospital classifications
Not later than 180 days after the date of the enactment of this Act, the Comptroller General of the United States shall submit to Congress a report on Medicare rural hospital classifications that includes the following information:
(1)
The total number of hospitals that, with respect to any of the 5 fiscal years preceding such date of enactment, had any of the following classifications:
(A)
Classification as a critical access hospital (as defined in section 1861(mm)(1) of the Social Security Act ( 42 U.S.C. 1395x(mm)(1) )).
(B)
Classification as a rural emergency hospital (as defined in section 1861(kkk)(2) of such Act ( 42 U.S.C. 1395x(kkk)(2) )).
(C)
Classification as a rural referral center (as described in section 1886(d)(5)(C) of such Act ( 42 U.S.C. 1395ww(d)(5)(C) ).
(D)
Classification as a sole community hospital (as defined in section 1886(d)(5)(D)(iii) of such Act ( 42 U.S.C. 1395ww(d)(5)(D)(iii) )).
(E)
Classification as a medicare-dependent, small rural hospital (as defined in section 1886(d)(5)(G)(iv) of such Act ( 42 U.S.C. 1395ww(d)(5)(G)(iv) )).
(F)
Classification as a low-volume hospital (as defined in section 1886(d)(12)(C)(i) of such Act ( 42 U.S.C. 1395ww(d)(12)(C)(i) )).
(2)
An analysis of the extent to which there is overlap between the criteria for any two or more of the classifications described in  paragraph (1) .
(3)
Recommendations for—
(A)
simplification with respect to such classifications and any such overlap; and
(B)
changes with respect to the criteria for such classifications that would promote financial sustainability for rural hospitals and improve access to health care for individuals in rural areas.
(4)
The projected effects of allowing sole community hospitals (as described in  paragraph (1)(D) ) and medicare-dependent, small rural hospitals (as described in  paragraph (1)(E) ) to use a cost reporting period beginning during fiscal year 2021 for the purpose of calculating adjusted payments under section 1886(d)(5) of the Social Security Act ( 42 U.S.C. 1395ww(d)(5) ).