Short title; table of contents

(a) Short title This Act may be cited as the Save America’s Rural Hospitals Act. (b) Findings Congress finds the following: (1) More than 60,000,000 individuals in rural areas of the United States rely on rural hospitals and other providers as critical access points to health care. (2) Access to health care is essential to communities that Americans living in rural areas call home. (3) Americans living in rural areas are older, poorer, and sicker than Americans living in urban areas. (4) As of May 1, 2025, 151 rural hospitals have closed in the United States, according to the University of North Carolina’s Cecil G. Sheps Center for Health Services Research, and the rate of these closures is increasing. (5) Four hundred and thirty-two hospitals are operating at margins similar to those that have closed over the past decade. Of those, 216 are considered most vulnerable to closure. (6) Rural Medicare beneficiaries already face a number of challenges when trying to access health care services close to home, including the weather, geography, and cultural, social, and language barriers. (7) Approximately sixty percent of all primary care health professional shortage areas are located in rural areas. (8) Seniors living in rural areas are forced to travel significant distances for care. (9) On average, trauma victims in rural areas must travel twice as far as victims in urban areas to the closest hospital, and, as a result, 60 percent of trauma deaths occur in rural areas, even though only 20 percent of Americans live in rural areas. (10) With the 432 hospitals on the brink of closure, millions of Americans living in rural areas are on the brink of losing access to the closest emergency room. (c) Table of contents The table of contents of this Act is as follows: Sec. 1. Short title; table of contents. Title I—Rural provider payment stabilization Subtitle A—Rural hospitals Sec. 101. Eliminating Medicare sequestration for rural hospitals. Sec. 102. Reversing cuts to reimbursement of bad debt for critical access hospitals (CAHs) and rural hospitals. Sec. 103. Permanently extending payment levels for low-volume hospitals and Medicare-dependent hospitals (MDHs). Sec. 104. Extending disproportionate share payments for sole community hospitals and medicare-dependent hospitals. Sec. 105. Rebasing target amounts for Medicare-dependent hospitals and sole community hospitals. Sec. 106. Implementing area wage index adjustments. Subtitle B—Other rural providers Sec. 111. Making permanent increased Medicare payments for ground ambulance services in rural areas. Sec. 112. Permanently extending Medicare telehealth service enhancements for federally qualified health centers and rural health clinics. Sec. 113. Restoring State authority to waive the 35-mile rule for certain Medicare critical access hospital designations. Title II—Rural Medicare beneficiary equity Sec. 201. Equalizing beneficiary copayments for services furnished by CAHs. Title III—Regulatory relief Sec. 301. Eliminating 96-hour requirements with respect to inpatient CAH services. Sec. 302. Eliminating hospitalization requirement for extended care services furnished by certain hospitals. Title IV—Future of rural health care Sec. 401. Medicare rural hospital flexibility program grants.