Rural ER Access Act

Bill Number

H.R. 772

Origin Chamber

House

Congress

119th Congress, Session 1

Policy Area

Health

Status

Introduced

Latest Action

2025-01-28: 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

2025-06-13T18:13:25Z

AI-Generated Summary

H.R. 772: Rural ER Access Act

Purpose

This bill aims to expand access to emergency room (ER) services in rural areas by easing Medicare rules for off-campus healthcare facilities. Specifically, it removes a geographic limit that currently restricts which facilities can qualify for special billing status under Medicare, potentially allowing more rural sites to operate and bill as part of a main hospital.

Key Provisions

• Short Title: The Act is named the "Rural ER Access Act."
• Regulatory Revision Requirement: The Secretary of Health and Human Services (HHS) must update a specific federal regulation (section 413.65(e)(3)(i) of title 42, Code of Federal Regulations, or any updated version) within 60 days of the bill's enactment.
• Core Change: The regulation will eliminate the rule requiring an off-campus facility or organization to be within a 35-mile radius of its main hospital or critical access hospital (a small, rural hospital type) to qualify for "provider-based status." This status allows the facility to bill Medicare at higher hospital rates rather than lower outpatient clinic rates.

Significant Changes to Existing Law

• Under current Medicare rules (from the Bipartisan Budget Act of 2015 and related regulations), off-campus facilities added after a certain date must be within 35 miles of the main hospital campus to maintain provider-based status and receive full Medicare reimbursement as part of the hospital.
• This bill directly repeals that mileage restriction, broadening eligibility without altering other criteria for provider-based status, such as ownership and clinical integration with the main provider.

Potential Impacts

• On Government Agencies: HHS will need to promptly revise and implement the regulatory change, potentially reducing administrative burdens in reviewing facility locations but increasing oversight to ensure compliance with remaining provider-based rules. The Centers for Medicare & Medicaid Services (CMS), part of HHS, may see shifts in Medicare reimbursements, possibly increasing federal spending on rural healthcare.
• On Citizens: Rural Medicare beneficiaries could gain better access to ER and outpatient services closer to home, as more distant facilities might qualify for hospital-level funding, reducing travel needs and improving emergency care availability. Urban areas are unlikely to be affected.
• On International Relations: No direct impacts, as the bill focuses solely on domestic U.S. healthcare policy.

Main Stakeholders Affected

• Rural Hospitals and Critical Access Hospitals: These can more easily establish or expand off-campus facilities (e.g., ERs or clinics) beyond 35 miles, improving financial viability through higher Medicare payments.
• Off-Campus Facilities and Organizations: Providers like standalone ERs or clinics affiliated with hospitals benefit from easier qualification for provider-based status, enabling them to offer services without geographic penalties.
• Medicare Beneficiaries in Rural Areas: Patients, especially the elderly or those in underserved regions, may experience enhanced healthcare access and affordability.
• Healthcare Providers and Insurers: Doctors, nurses, and private insurers dealing with Medicare patients could see operational changes, with potential cost shifts to the Medicare program.

Notable Legal, Constitutional, or Political Implications

• Legal Implications: The bill uses congressional authority to direct a regulatory change, which is a standard way to modify administrative rules without overhauling the broader Medicare statute. It avoids creating new entitlements, focusing instead on simplifying existing ones, and includes a tight 60-day deadline to ensure quick implementation.
• Constitutional Implications: None significant; the bill aligns with Congress's power to regulate interstate commerce and federal spending programs like Medicare, with no challenges to federalism or individual rights apparent.
• Political Implications: Introduced by Rep. Green of Tennessee, it targets rural healthcare disparities, which could appeal to lawmakers from rural districts. Referral to the House Committees on Energy and Commerce and Ways and Means signals bipartisan interest in Medicare reforms, though it may spark debate over federal healthcare costs.

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

Sponsor

Rep. Green, Mark E. [R-TN-7]

Recent Actions

• 2025-01-28: 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.
• 2025-01-28: 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.
• 2025-01-28: Introduced in House
• 2025-01-28: Introduced in House

Bill Versions

• Rural ER Access Act — issued 2025-01-28 — PDF (2 pages)