II 118th CONGRESS 2d Session S. 3691 IN THE SENATE OF THE UNITED STATES January 30, 2024 Mr. Sullivan (for himself, Mr. Schatz , Ms. Murkowski , and Ms. Hirono ) introduced the following bill; which was read twice and referred to the Committee on Finance A BILL To amend title XVIII of the Social Security Act to provide for the application of a cost-of-living adjustment to the non-labor related portion for hospital outpatient department services furnished in Alaska and Hawaii.

1. Short title This Act may be cited as the Ensuring Outpatient Quality for Rural States Act . 2. Application of cost-of-living adjustment to non-labor related portion for hospital outpatient department services furnished in Alaska and Hawaii Section 1833(t) of the Social Security Act ( 42 U.S.C. 1395l(t) ) is amended by adding at the end the following new paragraph: (23) Application of cost-of-living adjustment to non-labor related portion for hospital outpatient department services furnished in Alaska and Hawaii With respect to OPD services furnished on or after January 1, 2025, the Secretary may provide for adjustments to the payment amounts under this subsection for such services in the same manner that is provided under section 1886(d)(5)(H) with respect to the application of the cost-of-living adjustment to the non-labor related portion of such payment amounts to take into account the unique circumstances of hospitals located in Alaska or Hawaii. The preceding sentence shall not be applied in a budget neutral manner. .