Rural Surgery Sustainability Act of 2026
Raises Medicare payment limits for nurse anesthetist services and removes certain limits for hospitals with active labor and delivery units.
In the House Ways and Means Committee since Oct. 5, 2026, 3 days after it was introduced. Most bills never leave committee.
- INTRODUCEDINTROOCT 5, 2026
- COMMITTEECOMM.IN COMMITTEE
- HOUSEHOUSE—
- SENATESENATE—
- LAWLAW—
What the bill would do, and why it matters
Medicare uses special cost-based payment rules for some certified registered nurse anesthetist services. The bill would raise a surgical-procedure limit, remove certain limits for hospitals with active labor and delivery units, and adjust payment limits each year for medical inflation. It would also require reviews and a report on possible payment changes.
- INTRODUCED ONLY This bill has been introduced and possibly referred to a committee, but it has not passed any vote. Most introduced bills never become law — they die in committee without a hearing.
- DATA NOTE No Congressional Research Service summary was available.
- Raises the surgical-procedure limit
For Medicare's cost-based payment rules for certified registered nurse anesthetist services, the bill raises the surgical-procedure volume limit from 500 to 1,250. The limit would not apply to a hospital in a year when it has an active labor and delivery unit.
- Changes limits on anesthetist hours
The bill directs the Secretary of Health and Human Services to revise the limit on anesthetist service hours to reflect the higher surgical-procedure limit. For 2027 and later, no such hours limit would apply to a hospital with an active labor and delivery unit.
- Updates payment limits for inflation
For services paid on a reasonable-cost basis under this provision, the limit for each year would be the prior year's limit increased by that year's percentage increase in the Medicare Economic Index.
- Requires a review and report
The Secretary would review the surgical-procedure and anesthetist-hours limits at least once every two years, in consultation with the American Association of Nurse Anesthetists. The Medicare Payment Advisory Commission would report to Congress on paying for on-call certified registered nurse anesthetist services and possible sustainable payment changes.
The practical stakes are how Medicare's cost-based payment rules account for nurse anesthetist services and hospitals' surgical activity. The bill would change those limits and require a review of whether on-call services should be included and what payment changes could be sustainable.
Written from the bill text.
The path it took, step by step
- IntroducedOCT 5, 2026HOUSEOCT 5, 2026By Rep. DavidsReferred to Ways and Means
- SAME DAYNOWHouse committeeOCT 5, 2026WAYS & MEANS NOWOCT 5, 2026In committee for 3 daysNo hearing yet
- 3 DAYS SO FARPassed the House—HOUSE FLOOR—Not scheduled
- Senate committee—SENATE—
- Passed the Senate—SENATE FLOOR—Not scheduled
- Resolve differencesONLY IF NEEDEDBOTH CHAMBERSONLY IF NEEDEDSkipped if the other chamber passes the same text
- Signed into law—PRESIDENT—10 days to sign or veto
- OCT 52026OCT 5, 2026REFERREDHOUSEReferred to the House Committee on Ways and Means.
- OCT 52026OCT 5, 2026INTRODUCEDHOUSEIntroduced in House
At day 3, this bill is already older than 3% of the laws passed this Congress were when they were signed.
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