Physician Led and Rural Access to Quality Care Act
Summary
What This Bill Does
The Physician Led and Rural Access to Quality Care Act changes the physician self-referral law for rural physician-owned hospitals. It defines a covered rural hospital as a hospital in a rural area that, when it enrolls in Medicare, is more than a 35-mile drive from another hospital or critical access hospital, or more than a 15-mile drive in mountainous terrain or areas with only secondary roads. The bill exempts covered rural hospitals from certain Stark Law ownership restrictions and provides that the expansion-prohibition requirement no longer applies beginning on enactment. The practical effect is to let qualifying physician-owned hospitals enroll, maintain physician ownership, and expand capacity where rural geography limits access to other hospital care.
Who Benefits and How
Physician-owned rural hospitals benefit because covered facilities receive exemptions from ownership and expansion restrictions. Rural patients benefit if qualifying hospitals can open or expand in communities far from other hospitals or critical access hospitals. Physician owners benefit because ownership interests in covered rural hospitals face fewer Stark Law barriers. Rural hospital developers benefit from a clearer distance-based eligibility pathway for physician-led facilities.
Who Bears the Burden and How
CMS Stark Law staff must apply the new covered rural hospital definition and expansion exemption. Competing rural hospitals may face new or expanded physician-owned hospital competitors. Critical access hospitals near the distance threshold may face patient-volume competition from covered rural hospitals. Medicare program integrity reviewers must monitor self-referral risks under the new exemption.
Key Provisions
- Creates a covered rural hospital definition for physician self-referral exemptions.
- Requires rural location and distance from another hospital or critical access hospital.
- Uses a 35-mile drive test, or a 15-mile drive test in mountainous or secondary-road areas.
- Exempts covered rural hospitals from specified physician ownership and expansion restrictions.
Evidence Chain:
This summary is generated from the full bill text using AI analysis. Expand "Detailed Analysis" below for identified beneficiaries/burden bearers with clause-level evidence links.
At a Glance
What This Bill Does
Creates Stark Law exemptions for covered rural physician-owned hospitals and ends the expansion prohibition for those hospitals when they are in rural areas more than 35 miles, or 15 miles in mountainous or secondary-road areas, from another hospital or critical access hospital.
Key Policy Areas
Medicare, Rural Health, Hospitals, Physician Ownership
Primary Purpose
Creates Stark Law exemptions for covered rural physician-owned hospitals and ends the expansion prohibition for those hospitals when they are in rural areas more than 35 miles, or 15 miles in mountainous or secondary-road areas, from another hospital or critical access hospital.
Policy Domains
Resolution provisions
Identified Gains
- Physician-owned rural hospitals
- Rural patients
- Physician owners
- Rural hospital developers
Identified Costs
- CMS Stark Law staff
- Competing rural hospitals
- Critical access hospitals near the threshold
- Medicare program integrity reviewers
Sponsors
Legislative Progress
In CommitteeMr. Griffith (for himself, Mr. Hern of Oklahoma, Mr. Vicente …
Referred to the Committee on Energy and Commerce, and in …
Introduced in House
Stakeholder Effects
cui bono?How this legislation distributes effects. Mention counts reflect frequency, not effect magnitude.
Competing rural hospitals, Physician owners, Physician-owned rural hospitals
Positive-direction: Rural hospital developers
Negative-direction: Competing rural hospitals
CMS Stark Law staff, Medicare program integrity reviewers
Bill Structure & Actor Mappings
Who is "The Secretary" in each section?
We use a combination of our own taxonomy and classification in addition to large language models to assess meaning and potential beneficiaries. High confidence means strong textual evidence. Always verify with the original bill text.
Learn more about our methodology