Potential changes for the healthcare industry in the Big Beautiful Bill
President Trump’s 1,000-page Big Beautiful Bill (BBB), which passed in a 215 to 214 vote in the House last week, contains several provisions that will impact healthcare entities.
We have summarized several of them here with brief details. If you have questions or are unsure if there are implications for your hospital or practice, contact our healthcare advisory team.
Sec. 44132. Moratorium on new or increased provider taxes
This provision would prevent new state provider taxes and/or freeze existing provider tax rates at their level at the time this proposed legislation is signed into law. Important to note: If there is any future federal legislation that implemented new rates or increased rates, those would be allowed.
Sec. 44134. Requirements regarding waiver of uniform tax requirement for Medicaid provider tax
This provision seeks to provide clarification as to when and how states must use uniform data to set the provider’s taxes. In addition, this provision clarifies what a Medicaid and non-Medicaid taxable unit is.
Sec. 44303. Delaying DSH reductions
This provision moves the Medicaid DSH reductions from FFY 2026 to FFY 2028.
Sec. 111201. Expanding the definition of rural emergency hospital under the Medicare program
This provision seeks to expand the criteria and opportunities for hospitals to qualify as a rural emergency hospital (REH). The expansion requirements include provisions for REHs that are located within 35 miles of a CAH and/or PPS hospital by adding specific qualifying criteria.
In addition, beginning January 1, 2027, any hospital that had closed, but that had been a CAH or small rural hospital (under 50 beds) from January 1, 2014, through December 26, 2020, would be eligible to reopen as an REH if they meet the required criteria, and this provision is signed into law. The current legislation states that these facilities had to have been either a CAH or a small rural hospital (under 50 beds) as of December 27, 2020.
What’s next
We need to continue monitoring. These items are still under discussion and no bills have been passed yet. Some features may pass, some may not; others might change, and new ones could emerge. It is important to track potential changes while the bill is with the Senate. Congressional Republicans hope to have it passed for the President’s signature by July 4, 2025.
BNN’s team is watching this activity closely to share relevant information and updates with our clients and friends. For more information or a discussion on how this may impact your hospital, please contact Marc Levy or your BNN advisor at 800.244.7444.
Disclaimer of Liability: This publication is intended to provide general information to our clients and friends. It does not constitute accounting, tax, investment, or legal advice; nor is it intended to convey a thorough treatment of the subject matter.
