HR2191-119

In Committee

Physician Led and Rural Access to Quality Care Act

119th Congress Introduced Mar 18, 2025

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

Medicare Rural Health Hospitals Physician Ownership

Resolution provisions

Identified Gains
  • Physician-owned rural hospitals
  • Rural patients
  • Physician owners
  • Rural hospital developers
Model: codex-gpt-5 | Version: bill_summary_v2 | Source: ih
Rural patients:
Physician owners:
Rural hospital developers:
Physician-owned rural hospitals:
Identified Costs
  • CMS Stark Law staff
  • Competing rural hospitals
  • Critical access hospitals near the threshold
  • Medicare program integrity reviewers
Model: codex-gpt-5 | Version: bill_summary_v2 | Source: ih
CMS Stark Law staff:
Competing rural hospitals:
Medicare program integrity reviewers:
Critical access hospitals near the threshold:

Legislative Progress

In Committee
Introduced Committee Passed
Mar 18, 2025

Mr. Griffith (for himself, Mr. Hern of Oklahoma, Mr. Vicente …

Mar 18, 2025

Referred to the Committee on Energy and Commerce, and in …

Mar 18, 2025

Introduced in House

Stakeholder Effects

cui bono?

How this legislation distributes effects. Mention counts reflect frequency, not effect magnitude.

Health Care
5 mentions across 1 clause
+1 positive -1 negative ?3 uncertain

Competing rural hospitals, Physician owners, Physician-owned rural hospitals

Positive-direction: Rural hospital developers

Negative-direction: Competing rural hospitals

Government Employees
2 mentions across 1 clause
-2 negative

CMS Stark Law staff, Medicare program integrity reviewers

1/2
sections analyzed
Full impact breakdown

Bill Structure & Actor Mappings

Who is "The Secretary" in each section?

Domains
Medicare Rural Health Hospitals Physician Ownership

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