Bill Details
HR.1805 - 119th Congress
Status
Latest action
2025-03-03 - Referred to the House Committee on Ways and Means.
Introduced Date
2025-03-03
Policy Area
Health
Committees
View committees (1)
Cosponsors
5
0
0
AI Summary This summary was generated by AI from the bill text. AI can get information wrong.
This bill would keep extra Medicare payments in place for certain small rural hospitals for several more years, giving them more financial support through 2031 and 2032 instead of letting those payments expire in 2025. It also asks the Government Accountability Office to study how Medicare classifies rural hospitals, how much those categories overlap, and whether the system could be made simpler and more helpful for hospitals that serve rural communities. The goal is to help keep rural hospitals financially stable and preserve access to care for people who live far from major medical centers.
- It extends Medicare-dependent hospital payment rules through October 1, 2031.
- It extends low-volume hospital payment rules through fiscal year 2031, with one related date running into fiscal year 2032.
- It directs the Comptroller General to send Congress a report within 180 days on several rural hospital categories, including critical access hospitals, rural emergency hospitals, rural referral centers, sole community hospitals, Medicare-dependent small rural hospitals, and low-volume hospitals.
- The report must also look at overlaps between these categories and recommend ways to simplify the rules and improve the long-term financial health of rural hospitals.
Official Summaries
Assistance for Rural Community Hospitals Act or the ARCH Act
This bill extends through FY2031 (1) the Medicare-Dependent Hospital Program, which provides additional payments to certain small rural hospitals that have a high proportion of Medicare patients; and (2) certain increased payment adjustments for low-volume hospitals under Medicare's inpatient prospective payment system.
It also requires the Government Accountability Office to report on the number of hospitals that received certain classifications for purposes of payment under Medicare, including low-volume hospitals and Medicare-dependent hospitals.
Current Full Text
[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 1805 Introduced in House (IH)]
<DOC>
119th CONGRESS
1st Session
H. R. 1805
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.
_______________________________________________________________________
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.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Assistance for Rural Community
Hospitals Act'' or the ``ARCH Act''.
SEC. 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''.
SEC. 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)).
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