Allowing payments to be made based on allowable costs for services provided by any rural hospital that is located on a federally recognized Indian reservation.

The payment rate for eligible services at rural hospitals on Indian reservations increased from 140 percent to 150 percent of the fee-for-service rate.

The bill title was updated from 'Substitute Senate Bill' to 'Engrossed Substitute Senate Bill,' reflecting its progression through the legislative process.

A new payment rate of 140% of the fee-for-service rate was established for eligible rural hospitals on Indian reservations starting January 1, 2027.

Eligibility for the new payment rate is limited to rural hospitals on federally recognized Indian reservations that maintain no more than 25 inpatient beds, excluding psychiatric units.

The effective date for the new payment provision was set to January 1, 2027, whereas the original text referenced a 2026 designation date for Critical Access Hospitals.

The bill number was changed from S-3954.1 to S-4927.1, and the sponsor list was updated to include the Senate Ways & Means committee.