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[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[S. 3250 Introduced in Senate (IS)]
<DOC>
119th CONGRESS
1st Session
S. 3250
To amend title XVIII of the Social Security Act to reauthorize the
Rural Flex program, and for other purposes.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
November 20, 2025
Ms. Hassan (for herself, Mr. Barrasso, Ms. Cortez Masto, and Mrs.
Blackburn) introduced the following bill; which was read twice and
referred to the Committee on Finance
_______________________________________________________________________
A BILL
To amend title XVIII of the Social Security Act to reauthorize the
Rural Flex program, and for other purposes.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Rural Hospital Flexibility Act of
2025''.
SEC. 2. MEDICARE RURAL HOSPITAL FLEXIBILITY PROGRAM GRANTS.
Section 1820 of the Social Security Act (42 U.S.C. 1395i-4) is
amended--
(1) in subsection (g)--
(A) in paragraph (1)--
(i) in subparagraph (C), by striking
``and'' at the end;
(ii) by amending subparagraph (D) to read
as follows:
``(D) providing support for critical access
hospitals, rural health clinics, and rural emergency
hospitals (as defined in section 1861(kkk)(2)) for
quality improvement, quality reporting, performance
improvements, benchmarking, addressing population
health, transforming services, and providing linkages
and services for behavioral health and substance use
disorders responding to public health emergencies;'';
and
(iii) by adding at the end the following
new subparagraphs:
``(E) providing support for critical access
hospitals to convert to rural emergency hospitals to
stabilize hospital emergency services in their
communities; and
``(F) conducting outreach regarding the
availability of payments for direct graduate medical
education costs under section 1886(h), providing
information regarding eligibility for direct graduate
medical education residency positions, and providing
assistance with the application process for the
distribution of such positions to--
``(i) critical access hospitals;
``(ii) hospitals located in rural areas (as
defined in section 1886(d)(2)(D)), excluding
hospitals that are treated as being located in
a rural area pursuant to section 1886(d)(8)(E);
``(iii) hospitals located in an area that
has a rural-urban commuting code of no less
than 4.0;
``(iv) sole community hospitals (as defined
in section 1886(d)(5)(D)(iii));
``(v) sites that are located within 10
miles of a sole community hospital (as defined
in section 1886(d)(5)(D)(iii)); and
``(vi) rural emergency hospitals.'';
(B) by redesignating paragraphs (3) through (7) as
paragraphs (4) through (8), respectively;
(C) after paragraph (2), by inserting the following
new paragraph:
``(3) Activities to support carrying out other grants.--The
Secretary may award grants or cooperative agreements to
entities that submit to the Secretary applications, at such
time and in such form and manner and containing such
information as the Secretary specifies, for purposes of
supporting recipients in carrying out the activities under this
subsection by providing technical assistance, data analysis,
and evaluation efforts.'';
(D) in paragraph (4), as redesignated by
subparagraph (B)--
(i) in subparagraph (A)--
(I) in the header by striking
``hospitals'' and inserting ``State
offices of rural health''; and
(II) by inserting ``State Offices
of Rural Health on behalf of eligible
small rural'' after ``award grants
to'';
(ii) by amending subparagraph (B) to read
as follows:
``(B) Eligible small rural hospital defined.--For
purposes of this paragraph, the term ``eligible small
rural hospital'' means--
``(i) a non-Federal, short-term general
acute hospital that--
``(I) is located in a rural area
(as defined for purposes of section
1886(d)); and
``(II) has less than 50 beds; or
``(ii) a rural emergency hospital (as
defined in section 1861(kkk)(2)).'';
(iii) by amending subparagraph (C) to read
as follows:
``(C) Application.--The State Office of Rural
Health shall submit an application, on behalf of
eligible small rural hospitals, to the Secretary on or
before such date and in such form and manner as the
Secretary specifies.'';
(iv) by amending subparagraph (D) to read
as follows:
``(D) Amount of grant.--A grant under this
paragraph shall be determined on an equal national
distribution so that each eligible small rural hospital
receives the same amount of support related to the
funds appropriated.'';
(v) by amending subparagraph (E) to read as
follows:
``(E) Use of funds.--State Offices of Rural Health
and eligible small rural hospitals may use the funds
received through a grant under this paragraph for--
``(i) the purchase of computer software and
hardware;
``(ii) the education and training of
hospital staff on billing, operational, quality
improvement, and related value-focused efforts;
and
``(iii) other delivery system reform
programs determined appropriate by the
Secretary.''; and
(vi) in subparagraph (F)--
(I) in clause (i), by striking ``A
hospital receiving a grant under this
section'' and inserting ``An entity
receiving a grant under this
paragraph''; and
(II) in clause (ii), by striking
``under this section'' and inserting
``under this paragraph'' each place it
appears; and
(E) in paragraph (5), as redesignated by
subparagraph (B), in the matter preceding subparagraph
(A), by striking ``or (2)'' and inserting ``, (2), or
(4)''; and
(2) in subsection (j)--
(A) by striking ``from the Federal Hospital
Insurance Trust Fund''; and
(B) by striking ``in each of fiscal years 2011 and
2012'' and inserting ``in fiscal year 2011 and each
subsequent fiscal year''.
<all>
Introduced in Senate
Read twice and referred to the Committee on Finance.
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