This bill amends Medicare's payment system for hospital outpatient services to provide cost-of-living adjustments for Alaska and Hawaii starting January 1, 2025. Currently, Medicare payment rates for outpatient services in these states do not account for their significantly higher costs of living, which puts hospitals in rural Alaska and Hawaii at a financial disadvantage. The legislation allows the Secretary of Health and Human Services to adjust the non-labor portion of outpatient service payments in these two states using the same cost-of-living adjustment method already applied to inpatient hospital payments. Unlike most Medicare adjustments, this change will not be made on a budget-neutral basis, meaning it could increase overall Medicare spending to better support rural hospitals in these high-cost states. The bill was introduced in January 2024 by senators from Alaska and Hawaii.