S. 553 — SOLES Act

This section establishes additional payments under the Medicare hospital outpatient prospective payment system (OPPS) for sole community hospitals (SCHs, as defined in SSA section 1886(d)(5)(D)(iii), i.e., certain rural hospitals that are the sole source of inpatient hospital services in their area) located in Alaska or Hawaii. If the OPPS payment for covered outpatient department services furnished by such an SCH is less than 94% of the hospital's reasonable costs (as defined in SSA section 1861(v)), the payment is increased by the amount of such difference (i.e., to 94% of reasonable costs); these payments have no effect on beneficiary copayments, are not considered an adjustment under OPPS budget neutrality requirements, and require the Secretary to promulgate implementing regulations within six months of enactment, effective for services furnished on or after the first January 1 thereafter.