1. (a) The commission shall develop and implement a strategic plan to ensure that the citizens in this state residing in rural areas have access to hospital services.

2. (b) The strategic plan must include:

   1. (1) a proposal for using at least one of the following methods to ensure access to hospital services in the rural areas of this state:

      1. (A) an enhanced cost reimbursement methodology for the payment of rural hospitals participating in the Medicaid managed care program in conjunction with a supplemental payment program for rural hospitals to cover costs incurred in providing services to recipients;
      2. (B) a hospital rate enhancement program applicable only to rural hospitals;
      3. (C) a reduction of punitive actions under Medicaid that require reimbursement for Medicaid payments made to a rural hospital provider, a reduction of the frequency of payment reductions under Medicaid made to rural hospitals, and an enhancement of payments made under merit-based programs or similar programs for rural hospitals;
      4. (D) a reduction of state regulatory-related costs related to the commission's review of rural hospitals; or
      5. (E) in accordance with rules the Centers for Medicare and Medicaid Services adopts, the establishment of a minimum fee schedule that applies to payments made to rural hospitals by Medicaid managed care organizations;
   2. (2) target dates for achieving goals related to the proposal described by Subdivision (1); and

   3. (3) a rural hospital financial needs assessment and financial vulnerability index quantifying the likelihood that a rural hospital, during the next two-year period, will be able to:

      1. (A) maintain the types of patient services the hospital currently offers at the same level of service;
      2. (B) meet the hospital's current financial obligations; and
      3. (C) remain operational.

3. (c) Not later than December 1 of each even-numbered year, the State Office of Rural Hospital Finance established under Section 526.0304 shall submit a report regarding the development and implementation of the strategic plan to:

   1. (1) the legislature;
   2. (2) the governor; and
   3. (3) the Legislative Budget Board.

Added by Acts 2023, 88th Leg., R.S., Ch. 769 (H.B. 4611), Sec. 1.01, eff. April 1, 2025.

Acts 2025, 89th Leg., R.S., Ch. 707 (H.B. 18), Sec. 2, eff. June 20, 2025.