Legislation regarding rural hospitals and clinics: August 25, 2025 – October 9, 2025

From telehealth options, to forcing specific definitions of "rural" for funding purposes, to allowing rural clinics to be staffed by nurse practitioners and physician assistants... bipartisan!

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Prepared to be shocked. I bet you didn’t have Lauren Boebert (R-CO), Eugene Vindman (D-VA), Juan Ciscomani (R-AZ), and Jill Tokuda (D-HI) on your bingo card as cosponsors for several pieces of legislation!

This post separates out legislation that affects rural hospitals and clinics from the other “noise” surrounding Medicare and related healthcare issues. It appears that there may be a bit more bipartisanship on this topic than on most.

H.R.5081 - Telehealth Modernization Act. To amend title XVIII of the Social Security Act to extend certain telehealth flexibilities under the Medicare program.

Introduced September 2, 2025 by Earl Carter (R-GA). Cosponsored by three Democrats and no Republicans. Extends Medicare coverage for telehealth — with special focus on rural areas.

I don’t think most people realize that Medicare coverage of telehealth services expired on September 30, 2025. This legislation would extend it to September 30, 2027.

My question: Why not just make it permanent?

H.R.5198 - Rural Health Clinic Location Modernization Act of 2025. To amend title XVIII of the Social Security Act to maintain standards for qualification as a rural health clinic under the Medicare program.

Introduced September 8, 2025 by Tracey Mann (R-KS). Cosponsored by ten Democrats and seven Republicans. Lauren Boebert (R-CO) is a cosponsor.

This bill would change the definition of a rural hospital or clinic under Medicare from “is located in an area that is not an urbanized area (as defined by the Bureau of the Census)” to “(not) an urban area (as defined by the Bureau of the Census) with a population of 50,000 or more.” In other words, it prevents the Bureau of the Census from arbitrarily defining an area as “not rural.”

H.R.5199 - Modernizing Rural Physician Assistant and Nurse Practitioner Utilization Act of 2025. To amend title XVIII of the Social Security Act to modernize physician, physician assistant, and nurse practitioner utilization requirements.

Introduced September 8, 2025 by Tracey Mann (R-KS). Cosponsored by ten Democrats and seven Republicans. Again, Lauren Boebert (R-CO) is a cosponsor.

This bill would allow rural hospitals and clinics without a full-time physician on staff to qualify if they have one or more physician assistants, or one or more nurse practitioners.

H.R.5217 - Rural Behavioral Health Improvement Act of 2025. To amend title XVIII of the Social Security Act to remove certain limitations on the delivery of behavioral health services at rural health clinics under the Medicare program.

Introduced September 8, 2025 by Jill Tokuda (D-HI). Cosponsored by eight Republicans and seven Democrats. Another Boebert cosponsorship.

Amends the Social Security Act by striking the language that would eliminate behavioral health services at rural clinics from Medicare coverage. In other words, if this bill passes, Medicare would cover behavioral and mental health services provided by rural health clinics. (I frankly was unaware that Medicare did not cover mental health services at rural hospitals and clinics!)

September 10, 2025 alert. September 16, 2025 meeting. 2:00PM(EDT). Virtue Signaling vs. Vital Services: Where Tax-Exempt Hospitals are Spending Your Tax Dollars. Meeting Details – video of the three-hour meeting is available. No transcript or supporting documentation yet. Attempt by Trump loyalists to discredit hospitals as they strip them of Medicaid funding. Rural hospitals will be hit hard.

This sort of fealty to the Trump administration drives me nuts.

H.R.5496 - HEALTH Act of 2025 (Helping Ensure Access to Local TeleHealth Act of 2025). To amend title XVIII of the Social Security Act to provide for permanent payments for telehealth services furnished by federally qualified health centers and rural health clinics under the Medicare program.

Introduced September 18, 2025 by Glenn Thompson (R-PA). Cosponsored by Jill Tokuda (D-HI). See H.R.5081 above, with my question: Why not just make it permanent? -

This bill would do exactly that, make it permanent.

No proposed legislation regarding rural healthcare from September 18 - October 9, 2025.

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