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NRHA Statement on Ways and Means Rural Health Markup

NRHA CEO Alan Morgan released the following statement on the House Ways and Means Committee's markup on rural health legislation:

"Last week, the House Ways and Means Committee held a markup to discuss rural health legislation, including crucial extensions for telehealth, Medicare-dependent hospitals and low-volume payment adjustments, and rural ambulance add-on payments. Overall, NRHA commends the Committee for prioritizing rural health legislative priorities to support their rural constituents’ access to health care. We thank the Committee for temporary extensions of key rural programs and look forward to working together on permanent solutions to these issues.

Additionally, the Committee marked up legislation on Graduate Medical Education to ensure the new slots meant for rural hospitals reach geographically rural hospitals. NRHA is happy to support this legislation and applauds Representative Murphy for his dedication to increasing rural physician training. The Committee also considered the Second Chances for Rural Hospitals Act, to open eligibility for the Rural Emergency Hospital designation to hospitals closed after 2014. NRHA appreciates efforts to bring back care in rural communities but urges the House to consider retaining the current REH payment methodology for all hospitals that choose the designation."

The specific bills passed during this markup included:

  • H.R. 8261, Preserving Telehealth, Hospital, and Ambulance Access Act: Sponsored by Rep. David Schweikert and Rep. Mike Thompson, this bill would make Medicare telehealth flexibilities permanent. This includes making Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs) permanent distant site providers and retain audio-only visits. Additionally, it includes extension of increased inpatient hospital payment adjustment for low-volume hospital designations, the extension of Medicare-dependent hospital program, and extension of add-on payments for ambulance services. Please find W&M’s one-pager here.
  • H.R. 7931, Preserving Emergency Access in Key Sites (PEAKS) Act: Sponsored by Rep. Carol Miller and Rep. Yadira Caraveo, where under existing law, traditional Critical Access Hospitals (CAHs) are able to be reimbursed for their ambulance services, but those within 15 miles of mountainous terrain are ineligible for federal allowances for the ambulance services. The legislation would allow for CAHs that meet all the requirements of the ambulance allowance that fall within the 15-mile mountainous terrain classification to receive reimbursement for their ambulance services. Please find W&M’s one-pager here.
  • H.R. 8245, Rural Hospital Stabilization Act: Sponsored by Rep. Randy Feenstra, would authorize the Rural Hospital Stabilization Pilot Program through 2029, allowing struggling hospitals – especially those in the most rural areas – to improve financial stability and allow them to retain healthcare services and increase service capacity. This legislation would prioritize rural hospitals, those with smaller patient capacity, and those at most risk of closure. It would also ensure these funds may be utilized for renovations, training, hiring, compensation, and equipment purchases. Please find W&M’s one-pager here.
  • H.R. 8244, Ensuring Seniors’ Access to Quality Care Act: Sponsored by Rep. Ron Estes and Rep. Gerry Connolly, will allow nursing homes that have been forced to suspend in-house CNA education programs after receiving a certain level of penalties to resume those programs once quality standards are met. This bipartisan legislation will help to address a critical shortage of certified nursing assistants (CNAs). Please find W&M’s one-pager here.
  • H.R. 8235, Rural Physician Workforce Preservation Act: Sponsored by Rep. Murphy, ensures that 10% of graduate medical education (GME) slots created in the Consolidated Appropriations Act of 2021 and the Consolidated Appropriations Act of 2023 go to geographically rural hospitals. Please find W&M’s one-pager here.
  • H.R. 8246, Second Chances for Rural Hospitals Act: sponsored by Rep. Jodey Arrington, moves back the eligibility date for a closed hospital to convert to an REH, allowing previously closed rural hospitals to convert to an REH and bring back services to rural and underserved communities. Please find W&M’s one-pager here.


For further details of the markup please find the meeting information here and a summary from W&M here.

For additional information on NRHA’s legislative priorities please find NRHA’s legislative agenda here.

For supplementary material, please find NRHA’s rural telehealth legislative priorities here, NRHA’s rural EMS legislative priorities here, NRHA’s rural hospitals legislative priorities here, NRHA’s FQHCs priorities here, and NRHA’s RHCs priorities here.

Please contact Alexa McKinley Abel with any questions.

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Alexa McKinley

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