The SOLES Act amends Medicare payment rules to help rural hospitals in non-contiguous states, specifically Alaska and Hawaii. The bill establishes a payment floor for sole community hospitals, which are often the only emergency medical facilities in isolated areas, ensuring they receive at least 94 percent of what they were paid before the 1997 Balanced Budget Act when Medicare reduced their reimbursement rates. This change applies to outpatient services provided starting January 1, 2025, and affects the relatively small number of critical access hospitals in Alaska and Hawaii that serve as primary emergency providers for their regions. The bill does not specify new funding but instead redirects existing Medicare outpatient payment amounts to these hospitals. Senators Sullivan, Schatz, and Murkowski introduced the legislation in September 2024, recognizing that these remote hospitals struggle financially under current payment formulas and play a vital role in maintaining emergency medical access in remote communities.
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