The Rural Hospital Support Act seeks to bolster the financial viability of rural hospitals by updating their Medicare reimbursement methodologies. Specifically, it allows Sole Community Hospitals (SCHs) and Medicare-Dependent Hospitals (MDHs) to rebase their Medicare payment calculations. Starting October 1, 2025, these hospitals can use a 12-month cost reporting period from fiscal year 2016 as their new baseline for target amount calculations, but only if this substitution results in a greater payment amount. This provision aims to ensure that these critical rural facilities receive more equitable and up-to-date Medicare payments. Furthermore, the bill includes important extensions and protections for these hospital categories. It prohibits the Secretary from adjusting these rebased target amounts based on certain classification or weighting factor changes that occurred prior to October 1, 2015. Crucially, the legislation makes permanent the Medicare-Dependent Hospital (MDH) program , removing previous expiration dates for its payment methodology and target amount extensions. Additionally, it extends indefinitely the increased payments under the Medicare Low-Volume Hospital program , ensuring continued financial support for hospitals serving smaller patient populations. These combined measures provide long-term stability and improved reimbursement for rural healthcare providers.