Page 234

139 STAT. 304 PUBLIC LAW 119–21—JULY 4, 2025 (2) RURAL HOSPITAL.—The term ‘‘rural hospital’’ means the following: (A) A subsection (d) hospital (as defined in paragraph (1)(B) of section 1886(d) of the Social Security Act (42 U.S.C. 1395ww(d))) that— (i) is located in a rural area (as defined in para- graph (2)(D) of such section); (ii) is treated as being located in a rural area pursuant to paragraph (8)(E) of such section; or (iii) is located in a rural census tract of a metropoli- tan statistical area (as determined under the most recent modification of the Goldsmith Modification, originally published in the Federal Register on Feb- ruary 27, 1992 (57 Fed. Reg. 6725)). (B) A critical access hospital (as defined in section 1861(mm)(1) of such Act (42 U.S.C. 1395x(mm)(1))). (C) A sole community hospital (as defined in section 1886(d)(5)(D)(iii) of such Act (42 U.S.C. 1395ww(d)(5)(D)(iii))). (D) A Medicare-dependent, small rural hospital (as defined in section 1886(d)(5)(G)(iv) of such Act (42 U.S.C. 1395ww(d)(5)(G)(iv))). (E) A low-volume hospital (as defined in section 1886(d)(12)(C) of such Act (42 U.S.C. 1395ww(d)(12)(C))). (F) A rural emergency hospital (as defined in section 1861(kkk)(2) of such Act (42 U.S.C. 1395x(kkk)(2))). (3) STATE.—The term ‘‘State’’ means 1 of the 50 States or the District of Columbia. (4) TOTAL PUBLISHED MEDICARE PAYMENT RATE.—The term ‘‘total published Medicare payment rate’’ has the meaning given to such term in section 438.6(a) of title 42, Code of Federal Regulations (or a successor regulation). (5) WRITTEN PRIOR APPROVAL.—The term ‘‘written prior approval’’ has the meaning given to such term in section 438.6(c)(2)(i) of title 42, Code of Federal Regulations (or a successor regulation). (e) FUNDING.—There are appropriated out of any monies in the Treasury not otherwise appropriated $7,000,000 for each of fiscal years 2026 through 2033 for purposes of carrying out this section, to remain available until expended. SEC. 71117. REQUIREMENTS REGARDING WAIVER OF UNIFORM TAX REQUIREMENT FOR MEDICAID PROVIDER TAX. (a) IN GENERAL.—Section 1903(w) of the Social Security Act (42 U.S.C. 1396b(w)) is amended— (1) in paragraph (3)(E), by inserting after clause (ii)(II) the following new clause: ‘‘(iii) For purposes of clause (ii)(I), a tax is not considered to be generally redistributive if any of the following conditions apply: ‘‘(I) Within a permissible class, the tax rate imposed on any taxpayer or tax rate group (as defined in paragraph (7)(J)) explicitly defined by its relatively lower volume or percentage of Medicaid taxable units (as defined in paragraph (7)(H)) is lower than the tax rate imposed on any other taxpayer or tax rate group explicitly defined by its relatively higher volume or percentage of Medicaid taxable units. Time periods.