I 
119TH CONGRESS 
1ST SESSION H. R. 2191 
To amend title XVIII of the Social Security Act to revise certain physician 
self-referral exemptions relating to physician-owned hospitals. 
IN THE HOUSE OF REPRESENTATIVES 
MARCH 18, 2025 
Mr. GRIFFITH (for himself, Mr. HERN of Oklahoma, Mr. VICENTE GONZALEZ 
of Texas, Mr. JOYCE of Pennsylvania, Mr. CORREA, Mr. BALDERSON, 
Mr. VALADAO, Mr. PFLUGER, Mr. DUNN of Florida, Mr. DAVIS of North 
Carolina, Mr. YAKYM, Mr. WEBER of Texas, Mrs. MILLER-MEEKS, and 
Mr. AUSTIN SCOTT of Georgia) introduced the following bill; which was 
referred to the Committee on Energy and Commerce, and in addition to 
the Committee on Ways and Means, for a period to be subsequently de-
termined by the Speaker, in each case for consideration of such provisions 
as fall within the jurisdiction of the committee concerned 
A BILL 
To amend title XVIII of the Social Security Act to revise 
certain physician self-referral exemptions relating to phy-
sician-owned hospitals. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Physician Led and 
Rural Access to Quality Care Act’’. 
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SEC. 2. REVISING CERTAIN PHYSICIAN SELF-REFERRAL EX-
EMPTIONS RELATING TO PHYSICIAN-OWNED 
HOSPITALS. 
(a) IN GENERAL.—Section 1877 of the Social Secu-
rity Act (42 U.S.C. 1395nn) is amended— 
(1) in subsection (d)— 
(A) in paragraph (2)(C), by inserting 
‘‘(other than a covered rural hospital (as de-
fined in subsection (h)))’’ after ‘‘a hospital’’; 
and 
(B) in paragraph (3)(D), by inserting ‘‘in 
the case of a hospital other than a covered rural 
hospital (as defined in subsection (h)),’’ before 
‘‘the hospital’’; and 
(2) in subsection (h), by adding at the end the 
following new paragraph: 
‘‘(8) COVERED
RURAL
HOSPITAL.—The term 
‘covered rural hospital’ means a hospital that— 
‘‘(A) is located in a rural area (as defined 
in section 1886(d)(2)(D)); and 
‘‘(B) as of the date that such hospital en-
rolls under this title, is located more than a 35- 
mile drive (or, in the case of mountainous ter-
rain or in areas with only secondary roads 
available, a 15-mile drive) from a hospital or a 
critical access hospital.’’. 
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(b) ALLOWING FOR EXPANSION OF EXISTING PHYSI-
CIAN-OWNED HOSPITALS.—Section 1877(i) of the Social 
Security Act (42 U.S.C. 1395nn(i)) is amended— 
(1) in paragraph (1)(B), by striking ‘‘in para-
graph (3)’’ and inserting ‘‘in paragraph (3) or (7)’’; 
and 
(2) by adding at the end the following new 
paragraph: 
‘‘(7) SUNSET OF EXPANSION PROHIBITION.— 
The requirement described in paragraph (1)(B) shall 
not apply beginning on the date of the enactment of 
this paragraph.’’. 
Æ 
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