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To amend title XVIII of the Social Security Act to codify the Medicare low-wage index hospital policy.
Summary
The Save Struggling Hospitals Act would amend Medicare payment rules to codify the low-wage index hospital policy, which provides increased Medicare reimbursement to hospitals located in lower-wage areas. Under the policy, hospitals with an area wage index below the 25th percentile would receive a payment increase equal to half the difference between their current wage index and the 25th percentile wage index for all hospitals. The policy would be effective for hospital discharges beginning October 1, 2019, and would apply on an ongoing basis. To maintain budget neutrality, the adjustments must not decrease the wage index for hospitals below the 75th percentile and cannot reduce any hospital's wage index by more than 5 percent from the prior year. The bill effectively ensures that rural and other hospitals in lower-wage areas receive enhanced Medicare reimbursement rates through the codification of this administrative policy.
AI-generated plain-language summary of the bill text — neutral, and may be imperfect. See the full text below for the exact wording.
Sponsor (1)
- Rep. Kustoff, David [R-TN-8] (R-TN)
5 cosponsors
Actions (2)
- Mar 26, 2026 Referred to the House Committee on Ways and Means. · house
- Mar 26, 2026 Introduced in House
Similar bills (6)
Bills with similar text or summary — includes reintroductions across Congresses. Ranked by semantic similarity of the bill text (computed locally); a neutral discovery aid, not a claim the bills are duplicates.
Full text
IN THE HOUSE OF REPRESENTATIVES
March 26, 2026
Mr. Kustoff (for himself and Ms. Sewell) 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 codify the Medicare low-wage index hospital policy.
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 “Save Struggling Hospitals Act”.
SEC. 2. CODIFICATION OF THE MEDICARE LOW-WAGE INDEX HOSPITAL POLICY.
Section 1886(d)(3)(E) of the Social Security Act (42 U.S.C. 1395ww(d)(3)(E)) is amended—
(1) in clause (i), in the first sentence, by striking “or
(iv)” and inserting “, (iv), or (v)”; and
(2) by adding at the end the following new clause:
“(v) Area wage index adjustment for low- wage hospitals.—
“(I) In general.—For discharges occurring on or after October 1, 2019, the area wage index applicable under this subparagraph for a fiscal year to a hospital with an area wage index (determined without regard to this clause) below the 25th percentile area wage index shall be increased by \1/2\ of the difference between the otherwise applicable final area wage index for such fiscal year for such hospital and the 25th percentile area wage index for such fiscal year across all hospitals.
“(II) Budget neutrality.— Pursuant to the fourth sentence of clause (i), this clause shall be applied in a budget neutral manner. Any adjustments made for the purposes of such application of budget neutrality may not— “(aa) decrease the area wage index applicable under this subparagraph to a hospital with an area wage index (determined without regard to this clause) below the 75th percentile area wage index for the fiscal year; or “(bb) result in an area wage index applicable under this subparagraph to a hospital for such fiscal year that is less than 95 percent of the area wage index applicable under this subparagraph to such hospital for the preceding fiscal year.”. <all>
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