Summary of HR 3684: Save America’s Rural Hospitals Act

Bill Information:
- Bill Number: HR 3684
- Title: Save America’s Rural Hospitals Act
- Status: Introduced in House
- Introduced: June 03, 2025
- Classification: Bill

Purpose and Intent

The Save America’s Rural Hospitals Act aims to address the critical challenges faced by rural hospitals and healthcare providers in the United States. With over 60 million individuals in rural areas relying on these facilities for healthcare access, the bill seeks to stabilize and enhance the financial viability of rural hospitals, ensuring that residents can receive essential medical services close to home.

Key Provisions

The bill is structured into several titles, each focusing on different aspects of rural healthcare:

Title I: Rural Provider Payment Stabilization

• Subtitle A: Rural Hospitals

  • Sec. 101: Eliminates Medicare sequestration for rural hospitals.
  • Sec. 102: Reverses cuts to reimbursement of bad debt for Critical Access Hospitals (CAHs) and rural hospitals.
  • Sec. 103: Permanently extends payment levels for low-volume hospitals and Medicare-dependent hospitals (MDHs).
  • Sec. 104: Extends disproportionate share payments for sole community hospitals and MDHs.
  • Sec. 105: Rebases target amounts for MDHs and sole community hospitals.
  • Sec. 106: Implements area wage index adjustments.

• Subtitle B: Other Rural Providers

  • Sec. 111: Makes increased Medicare payments for ground ambulance services in rural areas permanent.
  • Sec. 112: Permanently extends Medicare telehealth service enhancements for federally qualified health centers and rural health clinics.
  • Sec. 113: Restores state authority to waive the 35-mile rule for certain Medicare CAH designations.

Title II: Rural Medicare Beneficiary Equity

• Sec. 201: Equalizes beneficiary copayments for services furnished by CAHs.

Title III: Regulatory Relief

• Sec. 301: Eliminates the 96-hour requirement for inpatient CAH services.
• Sec. 302: Eliminates the hospitalization requirement for extended care services provided by certain hospitals.

Title IV: Future of Rural Health Care

• Sec. 401: Establishes Medicare rural hospital flexibility program grants.

Impact

The Save America’s Rural Hospitals Act is designed to:
- Support Rural Hospitals: By providing financial relief and stability, the bill aims to prevent further closures of rural hospitals, which have seen a significant increase in closures in recent years.
- Enhance Access to Care: The provisions will help ensure that rural residents, particularly seniors and low-income individuals, can access necessary healthcare services without traveling long distances.
- Improve Emergency Response: By stabilizing rural hospitals, the bill seeks to reduce the trauma-related mortality rates that disproportionately affect rural populations.

Procedural Aspects

• Legislative Actions:

  • On June 3, 2025, the bill was referred to the Committee on Ways and Means, as well as the Committees on Energy and Commerce and Budget for consideration.

• Sponsors:

  • Primary Sponsor: Sam Graves
  • Cosponsor: Nikki Budzinski

This bill represents a significant legislative effort to bolster the healthcare infrastructure in rural America, addressing both immediate financial challenges and long-term sustainability for rural healthcare providers.