Physician Led and Rural Access to Quality Care Act

Bill Number

H.R. 2191

Origin Chamber

House

Congress

119th Congress, Session 1

Policy Area

Health

Status

Introduced

Latest Action

2025-03-18: Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.

Last Updated

2026-04-29T08:06:59Z

AI-Generated Summary

Purpose

The "Physician Led and Rural Access to Quality Care Act" (H.R. 2191) aims to modify rules under Medicare law that restrict physicians from referring patients to hospitals they own or invest in. It focuses on easing these restrictions for physician-owned hospitals, particularly in rural areas, to improve access to healthcare services where options are limited.

Key Provisions

• Exemptions for Rural Hospitals: Defines a "covered rural hospital" as one located in a rural area (per existing Medicare definitions) and at least 35 miles (or 15 miles in mountainous or secondary-road areas) driving distance from another hospital or critical access hospital, measured at the time of its Medicare enrollment.
• Ownership and Expansion Rules: Exempts covered rural hospitals from certain Medicare restrictions on physician ownership and hospital expansions that apply to other hospitals.
• End to Expansion Ban: Removes the longstanding prohibition on expanding existing physician-owned hospitals, effective immediately upon the bill's enactment.

Significant Changes to Existing Law

This bill amends Section 1877 of the Social Security Act (known as the Stark Law), which prohibits physicians from referring Medicare patients for certain services to entities in which they have a financial interest, to prevent conflicts of interest and overutilization. Key changes include:

• Carving out exceptions specifically for covered rural hospitals from ownership percentage limits and expansion approvals that previously applied broadly.
• Eliminating a 2010-era ban on physical expansions or increases in physician ownership for hospitals that had such ownership before that date, allowing unrestricted growth starting from the enactment date.

Potential Impacts

• On Citizens: Could enhance healthcare access for Medicare beneficiaries in rural areas by enabling more physician-led hospitals to operate and expand, potentially reducing travel distances for care and addressing shortages in underserved regions.
• On Government Agencies: The Centers for Medicare & Medicaid Services (CMS) would need to update enforcement and oversight of self-referral rules, possibly increasing administrative workload to verify rural exemptions but reducing barriers to new or expanded facilities.
• On International Relations: No direct impacts, as the bill is focused on domestic U.S. healthcare policy.
• Broader effects may include shifts in healthcare delivery patterns, with potential for more localized services but risks of increased Medicare spending if referrals lead to higher service volumes.

Main Stakeholders Affected

• Physicians and Hospital Owners: Benefits physician investors by lifting expansion limits and rural exemptions, allowing greater involvement in hospital operations.
• Rural Hospitals and Communities: Gains from easier establishment or growth of facilities in remote areas, improving local care options.
• Medicare Patients: Primarily older adults and disabled individuals relying on Medicare, who may see better access but could face indirect effects from any changes in referral patterns.
• General Hospitals and Health Systems: May face increased competition from physician-owned entities, particularly in rural markets.
• Federal Government (CMS and Congress): Responsible for implementation, monitoring compliance, and managing potential cost implications.

Notable Legal, Constitutional, or Political Implications

• Legal: Strengthens exceptions to the Stark Law, which could reduce litigation over self-referral violations but might invite challenges if perceived as favoring certain providers. Ensures compliance with Medicare enrollment rules for exemptions.
• Constitutional: No apparent issues, as it operates within Congress's authority over federal spending programs like Medicare.
• Political: Reflects bipartisan support (introduced by a mix of Republicans and Democrats) aimed at rural healthcare, potentially appealing to constituents in underserved areas. However, it revives debates on balancing anti-kickback protections against access needs, with critics possibly arguing it reopens doors to financial conflicts in healthcare.

This summary was generated by AI and may contain inaccuracies. Refer to the official source document for the authoritative text.

Sponsor

Rep. Griffith, H. Morgan [R-VA-9]

Cosponsors (33)

Rep. Hern, Kevin [R-OK-1], Rep. Gonzalez, Vicente [D-TX-34], Rep. Joyce, John [R-PA-13], Rep. Correa, J. Luis [D-CA-46], Rep. Balderson, Troy [R-OH-12], Rep. Valadao, David G. [R-CA-22], Rep. Pfluger, August [R-TX-11], Rep. Dunn, Neal P. [R-FL-2], Rep. Davis, Donald G. [D-NC-1], Rep. Yakym, Rudy [R-IN-2], Rep. Weber, Randy K. Sr. [R-TX-14], Rep. Miller-Meeks, Mariannette [R-IA-1], Rep. Scott, Austin [R-GA-8], Rep. McCormick, Richard [R-GA-7], Rep. Wilson, Joe [R-SC-2], Rep. Harris, Andy [R-MD-1], Rep. Van Duyne, Beth [R-TX-24], Rep. Sessions, Pete [R-TX-17], Rep. Evans, Gabe [R-CO-8], Rep. Tokuda, Jill N. [D-HI-2], Rep. Onder, Robert [R-MO-3], Rep. Higgins, Clay [R-LA-3], Rep. Bice, Stephanie I. [R-OK-5], Rep. Spartz, Victoria [R-IN-5], Rep. Bera, Ami [D-CA-6], Rep. Cloud, Michael [R-TX-27], Rep. Johnson, Julie [D-TX-32], Rep. Kennedy, Mike [R-UT-3], Rep. Moran, Nathaniel [R-TX-1], Rep. Smucker, Lloyd [R-PA-11], Rep. Rulli, Michael A. [R-OH-6], Rep. Carter, Earl L. "Buddy" [R-GA-1], Rep. Owens, Burgess [R-UT-4]

Recent Actions

• 2025-03-18: Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
• 2025-03-18: Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
• 2025-03-18: Introduced in House
• 2025-03-18: Introduced in House

Bill Versions

• Physician Led and Rural Access to Quality Care Act — issued 2025-03-18 — PDF (3 pages)

Related Bills

• S. 1390 (119th Congress)