I
119th CONGRESS
2d Session
H. R. 10731
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.
Short title
This Act may be cited as the Rural Surgery Sustainability Act of 2026
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Adjusting the cost pass-through for certified registered nurse anesthetists under the Medicare program
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—
in paragraph (2)—
by striking 500
and inserting 1,250
; and
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.
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by adding at the end the following new paragraphs:
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.
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.
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.
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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).
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—
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
potential sustainable payment modifications for services payable pursuant to such section.
Effective date
The amendments made by subsection (a) shall apply with respect to services furnished on or after January 1, 2027.