I 118th CONGRESS 2d Session H. R. 8245 IN THE HOUSE OF REPRESENTATIVES May 6, 2024 Mr. Feenstra introduced the following bill; which was referred to the Committee on Ways and Means A BILL To amend title XVIII of the Social Security Act to establish the Rural Hospital Stabilization Pilot Program to provide grants to rural hospitals for purposes of ensuring local access to services.

1. Short title This Act may be cited as the Rural Hospital Stabilization Act . 2. Rural Hospital Stabilization Pilot Program Section 1820(g) of the Social Security Act ( 42 U.S.C. 1395i–4 ) is amended by adding at the end the following new paragraph: (8) Rural Hospital Stabilization Pilot Program (A) In general Beginning January 1, 2026, the Secretary, acting through the Director of the Office of Rural Health Policy, shall award grants to— (i) hospitals, critical access hospitals, and rural emergency hospitals that are located in a rural area, as such term is used for purposes of section 711 of this Act (in this paragraph referred to as rural hospitals ) that have submitted applications to the Secretary, for purposes of assisting such hospitals in ensuring local access to services; and (ii) experienced technical assistance providers that have submitted applications to the Secretary, for purposes of assisting such rural hospitals in planning to apply for grants under this paragraph and using any amounts received under such a grant. (B) Prioritization factors In making grants to rural hospitals under this paragraph for a fiscal year (and determining the amount of each such grant), the Secretary shall consider the following factors: (i) The average daily census of the hospital. (ii) The distance between the hospital and the next nearest hospital. (iii) The financial circumstances of the hospital, as determined by such hospital’s most recently filed Medicare cost report (or other applicable source of information). (iv) The risk that the hospital will close. (v) The risk that the hospital will reduce or stop offering a class of services. (C) Use of funds (i) Hospitals Amounts received by a rural hospital under a grant under this paragraph shall be used to sustain, enhance, or expand the classes of services offered by such hospital, or to begin offering a new class of service, and may be used for— (I) minor renovations to buildings; (II) training with respect to the delivery of new or existing services; (III) recruiting or hiring new staff or supplementing compensation of existing staff; and (IV) equipment acquisition or refurbishment. (ii) Experienced technical assistance providers Amounts received by an experienced technical assistance provider under a grant under this paragraph shall be used to assist rural hospitals— (I) in applying for a grant under this paragraph; and (II) with respect to a rural hospital that has been awarded a grant under this paragraph, in using amounts received under such grant in accordance with the requirements of clause (i) . (D) Reports to Congress (i) Initial report Not later than January 1, 2029, the Secretary shall submit to Congress a report on the grants awarded under this paragraph that includes the following information: (I) The names of all experienced technical assistance providers that received a grant under this paragraph and, with respect to each such experienced technical assistance provider, an analysis of the use of the amounts received under such grant. (II) The names and locations of all rural hospitals that received a grant under this paragraph and, with respect to each such hospital— (aa) the use of the amounts received under such grant; (bb) an analysis of the financial circumstances of such hospital, as determined by such hospital’s most recently filed Medicare cost report (or other applicable source of information)— (AA) at the time of the receipt of such grant; and (BB) at the time the report is submitted under this clause; (cc) an analysis of the classes of services offered by the hospital— (AA) prior to the receipt of such grant; and (BB) following such receipt, as determined at the time the report is submitted under this clause; and (dd) an analysis of any new classes of services offered by the hospital following the receipt of such grant. (ii) Subsequent report Not later than 2 years after the initial report is submitted under clause (i) , the Secretary shall submit to Congress a subsequent report on the grants awarded under this paragraph that includes updates to the information described in subclauses (I) and (II) of such clause . (E) Funding There are authorized to be appropriated from the Federal Hospital Insurance Trust Fund under section 1817 for making grants under this paragraph, $20,000,000 for each of fiscal years 2026 through 2029, to remain available until expended. .