“To amend title XVIII of the Social Security Act to limit the geographic reclassification of certain hospitals under the Medicare program.”
No CRS summary available for this bill.
This section limits geographic reclassification of subsection (d) hospitals (i.e., acute care hospitals under Medicare's inpatient prospective payment system, or IPPS) to rural areas and prohibits dual reclassifications through the Medicare Geographic Classification Review Board (MGCRB). (As background, IPPS payments are higher for rural hospitals than urban ones; urban hospitals may seek reclassification to rural status or, via MGCRB, to a nearby urban area's higher wage index.) Specifically, with respect to rural reclassifications under SSA sec. 1886(d)(8)(E), it (1) restricts eligibility to urban hospitals (as defined in SSA sec. 1886(d)(2)(D)) meeting criteria in subclauses (I), (II), or (IV) of clause (ii) (or, for applications before October 1, 2026, any criteria in clause (ii)); (2) requires that a qualifying rural county under subclause (II) was so designated as of January 1, 2026; and (3) terminates such reclassifications on or after October 1, 2029, unless the hospital demonstrates it continues to meet criteria (I), (II), or (IV). (Thus, hospitals cannot indefinitely claim rural status without recertification.) With respect to MGCRB reclassifications under SSA sec. 1886(d)(10), for fiscal years beginning on or after October 1, 2026, it (1) prohibits Board approval of any application if the hospital is treated as rural under paragraph (8)(E) for that year and (2) renders any otherwise applicable reclassification ineffective during periods of such rural treatment.