AL SB331

Creates the Rural Hospital Transformation and Stability Act and establishes the Alabama Rural Hospital Global Budget Board to implement a pilot global budget program supporting rural hospital sustainability.

Limits initial participation to no more than 2 hospitals in the first year and 5 hospitals within the first three years, with hospitals required to be public or nonprofit organizations located in federally-designated rural shortage areas.

Requires participating counties, municipalities, or communities to contribute at least 10 percent of the global payment or current tax revenues to the hospital, whichever is greater, with participating insurers covering the remaining portion.

Mandates participation by Alabama Medicaid Agency (subject to federal approval), state employee health plans, Medicare Advantage plans, and the largest Alabama health care service plan in reimbursing participating hospitals through fixed global payments.

Participating hospitals must agree to achieve population health outcomes, access and quality targets, financial targets, and other performance measures established by the board, with the Rural Hospital Resource Center at UAB bearing all board operational costs.