Rural and Underserved Health Care Staffing Act

#7686 | HR Congress #119

Policy Area: Health
Subjects:

Last Action: Referred to the Committee on Education and Workforce, and in addition to the Committees on Energy and Commerce, Oversight and Government Reform, and House Administration, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned. (2/25/2026)

Bill Text Source: Congress.gov

Summary and Impacts
Original Text

Bill Summary

The "Rural and Underserved Health Care Staffing Act" is a legislative proposal aimed at formally recognizing the critical clinical roles of locum tenens physicians and advanced care practitioners, particularly in rural and underserved areas. The bill establishes a legal framework that classifies these healthcare providers as independent contractors rather than employees of healthcare entities, unless there is a written agreement establishing an employer-employee relationship.

Key provisions include:

1. **Definition of Locum Tenens**: The bill defines qualified locum tenens physicians and practitioners as those who provide temporary medical services at a single site for up to one year and are legally authorized to practice in their respective fields.

2. **Federal Recognition**: It clarifies that remuneration for locum tenens services will be treated as independent contractor income, impacting various federal laws, including labor standards, civil rights, and healthcare program compliance.

3. **State Law Considerations**: The bill explicitly states that it does not preempt state laws regarding professional licensure and does not modify tax obligations or eligibility for federal programs like Medicare and Medicaid.

4. **Implementation and Effective Date**: The bill mandates that relevant federal agencies implement its provisions, which will take effect for services performed after the bill's enactment.

Overall, this legislation aims to enhance the flexibility and availability of healthcare staffing in areas where there is often a shortage of medical professionals, ensuring continued access to care for underserved populations.

Possible Impacts

The "Rural and Underserved Health Care Staffing Act" as outlined in the provided legislation can have several impacts on various stakeholders. Here are three examples:

1. **Increased Access to Healthcare in Rural Areas:**
By recognizing and classifying locum tenens physicians as independent contractors rather than employees, this legislation can encourage more healthcare providers to work in rural and underserved areas. Locum tenens physicians can fill temporary gaps in staffing, which is critical for maintaining healthcare services in regions facing physician shortages. This means that patients in these areas are more likely to receive timely medical care, improving health outcomes.

2. **Financial Implications for Locum Tenens Physicians:**
Since locum tenens physicians are classified as independent contractors under this act, they may have different tax obligations and eligibility for benefits compared to traditional employees. For example, they would be responsible for their own self-employment taxes and may not have access to benefits like health insurance or retirement plans provided by an employer. This classification can affect their overall earnings and financial planning, requiring them to navigate additional complexities in tax and benefits management.

3. **Impact on Healthcare Facilities' Staffing Practices:**
Healthcare facilities may experience changes in how they manage staffing due to this legislation. By allowing locum tenens physicians to be classified as independent contractors, facilities may opt for more flexible staffing solutions without the long-term commitment associated with permanent hires. This could lead to a more dynamic workforce, but it also raises concerns about consistency in patient care, as temporary staff may not be as familiar with the facility's practices and protocols. Consequently, facilities may need to invest in robust orientation and training programs for locum tenens staff to ensure quality care.

[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 7686 Introduced in House (IH)]

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119th CONGRESS
  2d Session
                                H. R. 7686

     To recognize the importance of clinical roles of locum tenens 
                  physicians, and for other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                           February 25, 2026

Mr. Carter of Georgia introduced the following bill; which was referred 
  to the Committee on Education and Workforce, and in addition to the 
Committees on Energy and Commerce, Oversight and Government Reform, and 
House Administration, for a period to be subsequently determined by the 
  Speaker, in each case for consideration of such provisions as fall 
           within the jurisdiction of the committee concerned

_______________________________________________________________________

                                 A BILL


 
     To recognize the importance of clinical roles of locum tenens 
                  physicians, and for other purposes.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Rural and Underserved Health Care 
Staffing Act''.

SEC. 2. FEDERAL RECOGNITION OF LOCUM TENENS CLINICAL ROLES.

    (a) Classification of Locum Tenens Physicians.--
            (1) In general.--Subject to paragraph (2), for the purposes 
        of a Federal law or program described in subsection (b), with 
        respect to health services performed by an individual who is a 
        qualified locum tenens physician or advanced care 
        practitioner--
                    (A) such individual shall not be considered an 
                employee of the entity on behalf of which the services 
                are performed, including any contracting agency or 
                payor;
                    (B) such entity shall not be considered an employer 
                of such individual; and
                    (C) any remuneration paid or received for such 
                services shall be treated as remuneration for services 
                performed by an independent contractor.
            (2) Exception for express employer-employee relationship.--
        Paragraph (1) shall not apply with respect to any services for 
        which an individual and a health care facility (or a 
        contracting agency acting on behalf of a health care facility) 
        expressly agree, in a written contract, to enter into an 
        employer-employee relationship.
    (b) Federal Laws and Programs Described.--The Federal laws and 
programs described in this subsection are the following:
            (1) The Fair Labor Standards Act of 1938 (29 U.S.C. 201 et 
        seq.).
            (2) The National Labor Relations Act (29 U.S.C. 151 et 
        seq.).
            (3) Title VII of the Civil Rights Act of 1964 (42 U.S.C. 
        2000e et seq.).
            (4) The Americans with Disabilities Act (42 U.S.C. 12101 et 
        seq.).
            (5) The Family and Medical Leave Act (29 U.S.C. 2601 et 
        seq.).
            (6) The Employee Retirement Income Security Act of 1974 (29 
        U.S.C. 1001 et seq.).
            (7) The Public Health Service Act (42 U.S.C. 201 et seq.).
            (8) Any program administered by the Department of Health 
        and Human Services, to the extent that such program requires a 
        determination of whether an individual is an employee of a 
        health care facility (or a contracting agency acting on behalf 
        of a health care facility) for program participation, 
        certification, or compliance purposes.
    (c) Definitions.--In this section:
            (1) Qualified locum tenens physician or advanced care 
        practitioner.--The term ``qualified locum tenens physician or 
        advanced care practitioner'' means an individual who--
                    (A) provides temporary medical or clinical services 
                on a locum tenens basis at a single site for a period 
                not exceeding 1 continuous year;
                    (B) is--
                            (i) a doctor of medicine, osteopathy, 
                        dental surgery, or dental medicine legally 
                        authorized to practice in the State in which 
                        the individual performs such services;
                            (ii) a doctor of podiatric medicine or 
                        optometry legally authorized to practice in the 
                        State in which the individual performs such 
                        services;
                            (iii) a physician, as defined in--
                                    (I) section 1861(r) of the Social 
                                Security Act (42 U.S.C. 1395x(r)); or
                                    (II) section 8101(2) of title 5, 
                                United States Code; or
                            (iv) a nurse practitioner, physician 
                        assistant, or certified registered nurse 
                        anesthetist; and
                    (C) performs such services pursuant to a written 
                agreement between the individual and a health care 
                facility (or a contracting agency acting on behalf of a 
                health care facility).
            (2) State.--The term ``State'' means each of the several 
        States, the District of Columbia, and the territories and 
        possessions of the United States.
    (d) Rule of Construction.--Nothing in this Act shall be construed 
to--
            (1) affect or preempt State laws governing professional 
        licensure or scope of practice;
            (2) alter the application of the Internal Revenue Code of 
        1986 (26 U.S.C. 1 et seq.), including the imposition, 
        collection, or calculation of taxes under subtitle C of such 
        Code (such as taxes under the Federal Insurance Contributions 
        Act or Federal Unemployment Tax Act and related withholding) or 
        under chapter 2 of subtitle A of such Code (self-employment 
        tax);
            (3) alter the definition or treatment of the terms 
        ``wages'' or ``self-employment income'', or the calculation of 
        benefits, under title II of the Social Security Act (42 U.S.C. 
        401 et seq.);
            (4) affect eligibility for, benefit computation under, or 
        contributions to any Federal or State unemployment compensation 
        program; or
            (5) alter eligibility for participation or reimbursement 
        under--
                    (A) the Medicare program under title XVIII of the 
                Social Security Act (42 U.S.C. 1395 et seq.);
                    (B) the Medicaid program under title XIX of such 
                Act (42 U.S.C. 1396 et seq.); or
                    (C) any other federally supported health program.
    (e) Administration.--This section shall be implemented, as 
applicable, by the heads of the Federal departments and agencies 
responsible for administering the Federal laws and programs described 
in subsection (b). The Secretary of Health and Human Services shall 
implement this section with respect to the programs described in 
subsection (b)(8).
    (f) Effective Date.--This section shall only apply to services 
performed on or after the date of enactment of this Act. Nothing in 
this section shall affect the interpretation of any applicable law with 
respect to services performed before such date of enactment.
    (g) Severability.--If any provision of this section, or the 
application of such provision to any person or circumstance, is held to 
be unconstitutional, the remainder of this section, and the application 
of the remaining provisions, shall not be affected.
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