Rural and Underserved Health Care Staffing Act
- Bill Number
- H.R. 7686
- Origin Chamber
- House
- Congress
- 119th Congress, Session 2
- Policy Area
- Health
- Status
- Introduced
- Latest Action
- 2026-02-25: Referred to the Committee on Education and Workforce, and in addition to the Committees on Energy and Commerce, Oversight and Government Reform, and House Administration, 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
- 2026-05-13T08:06:33Z
AI-Generated Summary
Purpose of the Legislation
The Rural and Underserved Health Care Staffing Act (H.R. 7686) aims to support healthcare staffing in rural and underserved areas by formally recognizing the role of temporary physicians and advanced care providers (known as locum tenens). It clarifies their employment status under federal laws to make it easier for healthcare facilities to hire them without treating them as full-time employees, thereby addressing shortages in medical services.
Key Provisions
- Classification as Independent Contractors: Qualified locum tenens physicians or advanced care practitioners are treated as independent contractors (self-employed workers, not employees) for specific federal laws and programs when providing temporary health services. This means:
- They are not considered employees of the healthcare facility or any contracting agency.
- Payments for their services are handled as contractor fees, not employee wages.
- Exception for Employee Agreements: This independent contractor status does not apply if the individual and facility (or agency) sign a written contract explicitly creating an employer-employee relationship.
- Applicable Federal Laws and Programs:
- Fair Labor Standards Act (overtime and minimum wage rules).
- National Labor Relations Act (union and collective bargaining rights).
- Title VII of the Civil Rights Act (anti-discrimination in employment).
- Americans with Disabilities Act (protections against disability discrimination).
- Family and Medical Leave Act (unpaid leave for health or family reasons).
- Employee Retirement Income Security Act (employee benefits like pensions).
- Public Health Service Act (federal health initiatives).
- Any Department of Health and Human Services (HHS) programs that determine employee status for participation, certification, or compliance.
- Definitions:
- Qualified Locum Tenens: An individual providing temporary medical or clinical services at one location for up to one continuous year. They must be licensed professionals such as doctors (medicine, osteopathy, dentistry, podiatry, optometry), physicians under Social Security or federal definitions, or advanced practitioners like nurse practitioners, physician assistants, or certified registered nurse anesthetists. Services must be under a written agreement with a healthcare facility or agency.
- State: Includes all U.S. states, the District of Columbia, and territories.
- Limitations (Rule of Construction): The act does not:
- Change state rules on professional licensing or practice scope.
- Affect federal tax laws, including payroll taxes, self-employment taxes, or withholding.
- Alter Social Security benefits, unemployment insurance, or eligibility for Medicare, Medicaid, or other federal health programs.
- Implementation and Effective Date: Federal agencies (e.g., HHS for its programs) must enforce this. It applies only to services after the date of enactment and includes a severability clause (if one part is ruled invalid, the rest remains in effect).
Significant Changes to Existing Law
- Introduces a clear federal exemption for locum tenens workers from employee classification under key labor, civil rights, and benefits laws, unless explicitly agreed otherwise. Previously, these workers' status could be ambiguous, leading to potential misclassification lawsuits or compliance issues.
- Limits the scope to temporary roles (up to one year at a single site), providing a targeted carve-out without broadly redefining independent contractor rules across all industries.
Potential Impacts
- On Government Agencies: Agencies like the Department of Labor, Equal Employment Opportunity Commission, and HHS must update guidance and enforcement to reflect this classification, potentially reducing administrative burdens in auditing healthcare staffing but requiring new training or rules.
- On Citizens: Improves access to healthcare in rural and underserved areas by facilitating easier hiring of temporary providers, which could shorten wait times and address physician shortages. However, these workers may forgo certain employee protections (e.g., overtime pay) unless they negotiate an employee contract.
- On Healthcare Facilities: Lowers costs and legal risks for facilities by avoiding employer responsibilities like benefits or labor law compliance for temporary staff, encouraging more use of locum tenens to fill gaps.
- On International Relations: No direct impact, as the bill focuses on domestic U.S. healthcare and labor laws.
Main Stakeholders Affected
- Locum Tenens Physicians and Advanced Practitioners: Gain clarity on their independent status, potentially simplifying contracts and taxes but possibly losing automatic access to employee benefits.
- Healthcare Facilities (Especially Rural/Underserved): Benefit from flexible staffing options without full employer liabilities, aiding recruitment in shortage areas.
- Contracting Agencies: Staffing firms can operate more predictably under federal rules.
- Federal Agencies: Including HHS, Department of Labor, and others responsible for the listed laws, which must adapt enforcement.
- Patients and Communities: Indirectly affected through improved healthcare availability in underserved regions.
Notable Legal, Constitutional, or Political Implications
- Legal: Reduces litigation risks over worker misclassification (a common issue in gig and temporary work) by providing statutory clarity, while preserving core protections through exceptions and non-interference with taxes, benefits, and health program eligibility. The severability clause strengthens its resilience against court challenges.
- Constitutional: Aligns with federal authority over interstate commerce and labor standards (under the Commerce Clause), without infringing on states' rights to regulate professional licensing.
- Political: Supports bipartisan goals of rural healthcare access and workforce flexibility, potentially appealing to agricultural states and healthcare advocates, but could face criticism from labor groups concerned about eroding worker protections in a broader "gig economy" context.
This summary was generated by AI and may contain inaccuracies. Refer to the official source document for the authoritative text.
Sponsor
Rep. Carter, Earl L. "Buddy" [R-GA-1]
Cosponsors (1)
Recent Actions
- 2026-02-25: Referred to the Committee on Education and Workforce, and in addition to the Committees on Energy and Commerce, Oversight and Government Reform, and House Administration, 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.
- 2026-02-25: Referred to the Committee on Education and Workforce, and in addition to the Committees on Energy and Commerce, Oversight and Government Reform, and House Administration, 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.
- 2026-02-25: Referred to the Committee on Education and Workforce, and in addition to the Committees on Energy and Commerce, Oversight and Government Reform, and House Administration, 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.
- 2026-02-25: Referred to the Committee on Education and Workforce, and in addition to the Committees on Energy and Commerce, Oversight and Government Reform, and House Administration, 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.
- 2026-02-25: Introduced in House
- 2026-02-25: Introduced in House
Bill Versions
- Rural and Underserved Health Care Staffing Act — issued 2026-02-25 — PDF (7 pages)