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This bill would let Medicare make higher payment adjustments for hospital outpatient services in Alaska and Hawaii to better reflect the higher cost of living in those states. Starting January 1, 2026, the Health and Human Services Secretary could apply a cost-of-living adjustment to the part of the payment that does not cover labor costs, using the same general approach already used for some hospital payments. The goal is to recognize the special challenges faced by hospitals in these two states, and the bill says the change would not have to be paid for by lowering Medicare payments elsewhere.
- Applies only to hospital outpatient department services in Alaska and Hawaii.
- Would begin for services furnished on or after January 1, 2026.
- Lets the Secretary of Health and Human Services make payment adjustments for the non-labor part of the Medicare payment.
- States that the adjustment does not have to be budget neutral, meaning it would not be offset by cuts in other Medicare payments.
Official Summaries
Ensuring Outpatient Quality for Rural States Act
This bill allows Medicare payments for covered hospital outpatient services in Alaska or Hawaii to include certain cost-of-living adjustments.
Current Full Text
[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[S. 551 Introduced in Senate (IS)]
<DOC>
119th CONGRESS
1st Session
S. 551
To amend title XVIII of the Social Security Act to provide for the
application of a cost-of-living adjustment to the non-labor related
portion for hospital outpatient department services furnished in Alaska
and Hawaii.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
February 12, 2025
Mr. Sullivan (for himself, Mr. Schatz, and Ms. Murkowski) introduced
the following bill; which was read twice and referred to the Committee
on Finance
_______________________________________________________________________
A BILL
To amend title XVIII of the Social Security Act to provide for the
application of a cost-of-living adjustment to the non-labor related
portion for hospital outpatient department services furnished in Alaska
and Hawaii.
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 ``Ensuring Outpatient Quality for
Rural States Act''.
SEC. 2. APPLICATION OF COST-OF-LIVING ADJUSTMENT TO NON-LABOR RELATED
PORTION FOR HOSPITAL OUTPATIENT DEPARTMENT SERVICES
FURNISHED IN ALASKA AND HAWAII.
Section 1833(t) of the Social Security Act (42 U.S.C. 1395l(t)) is
amended by adding at the end the following new paragraph:
``(23) Application of cost-of-living adjustment to non-
labor related portion for hospital outpatient department
services furnished in alaska and hawaii.--With respect to
covered OPD services furnished on or after January 1, 2026, the
Secretary may provide for adjustments to the payment amounts
under this subsection for such services in the same manner that
is provided under section 1886(d)(5)(H) with respect to the
application of the cost-of-living adjustment to the non-labor
related portion of such payment amounts to take into account
the unique circumstances of hospitals located in Alaska or
Hawaii. The preceding sentence shall not be applied in a budget
neutral manner.''.
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