119-hr1805

[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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