Rural Surgery Sustainability Act of 2026

[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 10731 Introduced in House (IH)]

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119th CONGRESS
  2d Session
                               H. R. 10731

    To adjust the cost pass-through for certified registered nurse 
                anesthetists under the Medicare program.

_______________________________________________________________________

                    IN THE HOUSE OF REPRESENTATIVES

                            October 5, 2026

Ms. Davids of Kansas introduced the following bill; which was referred 
                   to the Committee on Ways and Means

_______________________________________________________________________

                                 A BILL

 
    To adjust the cost pass-through for certified registered nurse 
                anesthetists under the Medicare program.

    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 Surgery Sustainability Act of 
2026''.

SEC. 2. ADJUSTING THE COST PASS-THROUGH FOR CERTIFIED REGISTERED NURSE 
              ANESTHETISTS UNDER THE MEDICARE PROGRAM.

    (a) In General.--Section 9320(k) of the Omnibus Budget 
Reconciliation Act of 1986, as added by section 608(c) of the Family 
Support Act of 1988 and as amended by section 6132 of the Omnibus 
Budget Reconciliation Act of 1989, is amended--
            (1) in paragraph (2)--
                    (A) by striking ``500'' and inserting ``1,250''; 
                and
                    (B) by adding at the end the following new 
                sentence: ``The preceding sentence shall not apply to a 
                hospital for a year in the case such hospital has an 
                active labor and delivery unit during such year.''.
            (2) by adding at the end the following new paragraphs:
            ``(4) The Secretary shall, not less frequently than once 
        every 2 years and in consultation with the American Association 
        of Nurse Anesthetists, review the limit on the volume of 
        surgical procedures applicable under paragraph (2) and the 
        limit on the total number of hours of service furnished by 
        anesthetists under section 412.113(c)(2)(i)(B) of title 42, 
        Code of Federal Regulations (or a successor regulation), and 
        update such limits to reflect any general increase in the 
        frequency of furnishing such procedures, including any such 
        increase attributable to new procedures.
            ``(5) Notwithstanding paragraph (3), in applying any limit 
        on payment for services furnished during a year payable on a 
        reasonable cost basis pursuant to this subsection, the 
        Secretary shall set such limit at an amount equal to the limit 
        on such payment that would have applied to such services if 
        furnished in the preceding year, increased by the percentage 
        increase in the MEI (as defined in section 1842(i)(3) of the 
        Social Security Act) for such year.
            ``(6) The Secretary shall revise section 
        412.113(c)(2)(i)(B) of title 42, Code of Federal Regulations 
        (or a successor regulation), to ensure that, for 2027 and each 
        subsequent year, no limit on the total number of hours of 
        service furnished by anesthetists applies in the case of a 
        hospital that has an active labor and delivery unit during such 
        year.''.
    (b) Revision of Number of Hours Limit.--The Secretary of Health and 
Human Services shall revise the limit on the total number of hours of 
service furnished by anesthetists applicable under section 
412.113(c)(2)(i)(B) of title 42, Code of Federal Regulation, for 
services furnished on or after January 1, 2027, in a manner that 
reflects the increase in the limit on the volume of surgical procedures 
provided under the amendment made by subsection (a)(1).
    (c) Report.--Not later than 1 year after the date of the enactment 
of this Act, the Medicare Payment Advisory Commission shall submit to 
Congress a report on--
            (1) including on-call certified registered nurse 
        anesthetist services as services payable pursuant to section 
        9320(k) of the Omnibus Budget Reconciliation Act of 1986; and
            (2) potential sustainable payment modifications for 
        services payable pursuant to such section.
    (d) Effective Date.--The amendments made by subsection (a) shall 
apply with respect to services furnished on or after January 1, 2027.
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