HB450 Alabama 2018 Session

Summary

Primary Sponsor

David StandridgeRepresentative

Republican

Session

Regular Session 2018

Title

Rural Hospital Transformation and Stability Act, Ala. Rural Hospital Global Budget Board established, funding for rural hospitals accepted into program through global payment from certain insurers

Summary

The Rural Hospital Transformation and Stability Act would create a board to run a pilot global-budget system that provides stable funding to eligible rural hospitals through fixed global payments funded by insurers and local communities.

What This Bill Does

It establishes a new Alabama Rural Hospital Global Budget Board to design and run a pilot program. Eligible rural hospitals (public or nonprofit) can voluntarily join and would receive a fixed global payment funded by participating payors and local governments, with targets on population health, access, quality, and finances. The board would define participation rules, set payments, and work with insurers and CMS to enable participation.

Who It Affects

• Rural, public or nonprofit hospitals located in designated rural areas may participate voluntarily and receive a global payment.
• Participating payors (Medicaid, Medicare Advantage plans, the largest health care service plan in Alabama, and other payors) would reimburse hospitals through the global budget.
• Counties, municipalities, or communities would contribute at least 10% of the global payment or the tax revenues currently allocated to the hospital.
• Residents and patients in the hospital service areas could be affected by changes in access, population health outcomes, and care quality due to the program.

Key Provisions

• Creates the Alabama Rural Hospital Global Budget Board with defined membership and chair (the Medicaid Commissioner).
• Authorizes a pilot global budget program to support rural hospital sustainability and transformation.
• Defines global payment and service area; requires hospitals to meet criteria and participate voluntarily.
• Funding structure: local governments must contribute at least 10% of the global payment or current tax revenues; payors contribute the rest proportionally to the service-area population.
• Payors required to participate: Medicaid (subject to CMS approval), state employee health plans, Medicare Advantage plans, and the largest Alabama health plan; others may participate.
• Board can set participation criteria, cap participants (2 in year 1, up to 5 by year 3), and adopt rules.
• Participation requires hospitals be public/nonprofit, rural-designated, and have community funding commitments; board can allow exceptions if needed.
• CMS approval is required for Medicaid participation; other payors may participate by providing global payments.
• Board may terminate the program if it is ineffective or unsustainable; the Rural Hospital Resource Center bears the board's costs.
• Effective date: immediately upon passage and governor’s signature.

AI-generated summary using openai/gpt-5-nano on Feb 24, 2026. May contain errors — refer to the official bill text for accuracy.

Subjects

Health Care