SB1534 • 2026

rural hospitals; stability assessment; distribution

SB1534 - rural hospitals; stability assessment; distribution

Healthcare Taxes

Passed Legislature

This bill passed both chambers and reached final enrollment, even if later executive action is not shown here.

Sponsor: Priya Sundareshan
Last action: 2026-02-03
Official status: Senate second read
Effective date: Not listed

Plain English Breakdown

The official text states the bill passed both chambers, but the effective date depends on a two-thirds vote and governor signature which are procedural steps not fully detailed in the excerpt.

Rural Hospital Stability Assessment and Fund Distribution

This law requires certain limited-service rural hospitals to pay a fee that is kept within their county to support eligible general hospitals providing essential care.

What This Bill Does

Creates a 'community stability assessment' equal to four percent of net patient revenue for specific hospitals starting January 1, 2027.
Establishes the Rural Safety Net Fund to hold money collected from this assessment.
Requires that funds collected in one county can only be given back to eligible hospitals within that same county.
Sets rules so only general hospitals providing at least two core safety net services and serving many Medicaid or uninsured patients can receive funds.
Mandates annual reports on emergency room visits, admissions, transfers, and payment sources for all rural county hospitals.

Who It Names or Affects

Limited service hospitals operating in counties with fewer than 500,000 people that must pay the assessment.
General hospitals in rural counties that meet specific service and patient mix requirements to receive funds.
The state department responsible for collecting money, managing the fund, and publishing public reports.

Terms To Know

Limited Service Hospital: A hospital with an emergency room that does not offer at least two core safety net services like trauma care or labor delivery.
Core Safety Net Service: Essential medical services including 24-hour obstetrics, inpatient mental health, a designated trauma center, or a neonatal intensive care unit.
Rural County: Any county with a population of less than five hundred thousand people.

Limits and Unknowns

The law does not specify the exact date it becomes effective beyond requiring legislative approval and governor signature.
The text defines eligibility for receiving funds but does not detail how much money each eligible hospital will receive or the distribution formula.
The bill requires a two-thirds vote in both houses of the legislature to pass, which is noted as a requirement rather than an outcome.

Bill History

2026-02-03 Senate
Senate second read
2026-02-02 Senate
Senate Rules: None
2026-02-02 Senate
Senate Finance: None
2026-02-02 Senate
Senate Appropriations, Transportation and Technology: None
2026-02-02 Senate
Senate first read

Official Summary Text

SB1534 - rural hospitals; stability assessment; distribution

Current Bill Text

Read the full stored bill text

SB1534 - 572R - I Ver

REFERENCE TITLE:
rural hospitals; stability assessment; distribution

State of Arizona

Senate

Fifty-seventh Legislature

Second Regular Session

2026

SB 1534

Introduced by

Senator
Sundareshan

AN
ACT

Amending title 36, chapter 4, Arizona
Revised Statutes, by adding article 12; relating to health care institutions.

(TEXT OF BILL BEGINS ON NEXT PAGE)

Be it enacted by the Legislature of the State of Arizona:

Section 1. Title 36, chapter 4, Arizona Revised
Statutes, is amended by adding article 12, to read:

ARTICLE 12. RURAL COUNTY
HOSPITAL SAFETY NET INTEGRITY

START_STATUTE
36-450.11.

Definitions

In this article, unless the context otherwise
requires:

1. "Core safety net
service" means any of the following:

(
a
) Obstetrics
and labor and delivery services available twenty-four hours a day.

(
b
) Inpatient
behavioral health or psychiatric services.

(
c
) A level I,
II or III trauma center designation.

(
d
) A neonatal
intensive care unit.

2. "Limited service
hospital" means a health care institution that is licensed as a general
hospital or special hospital and that operates an emergency department, but
does not provide at least two core safety net services.

3. "Rural county" means a
county with a population of less than five hundred thousand persons.
END_STATUTE

START_STATUTE
36-450.12.

Community stability assessment; limited service hospitals

Beginning January 1, 2027:

1. A limited service hospital that
operates in a rural county shall pay a community stability assessment equal to
four percent of the hospital's net patient revenue.

2. The director shall collect the
assessment annually and deposit the monies in the rural safety net fund
established by section 36-450.13.
END_STATUTE

START_STATUTE
36-450.13.

Rural safety net fund; distributions; hospital eligibility

A. The rural safety net fund is
established consisting of monies collected pursuant to section 36-450.12.
The department shall administer the fund.� Monies in the fund are continuously
appropriated and are exempt from the provisions of section 35-190
relating to lapsing of appropriations.

B. Monies in the fund shall be
segregated by county. Monies collected from a limited service hospital in a
specific county may be distributed only to eligible hospitals in that same
county.

C. To be eligible to receive monies
from the fund, a hospital must:

1. Be licensed as a general hospital
in the applicable rural county.

2. Provide at least two core safety
net services.

3. Have a payor mix composed of at
least twenty percent medicaid or uninsured patients.
END_STATUTE

START_STATUTE
36-450.14.

Annual report; posting

A. On
or before March 1 of each year, each hospital in a rural county shall submit a
report to the department that details all of the following for the previous
calendar year:

1. The total number of patients who
presented to the hospital's emergency department.

2. The total number of patients who
were admitted to the hospital.

3. The total number of patients who
were transferred to another acute care hospital after stabilization.

4. The primary payor source for
patients who were retained in the hospital versus patients who were transferred
to another hospital.

B. The department shall annually
publish the data reported under subsection A of this section on its public
website.
END_STATUTE

Sec. 2.
Requirements for enactment; two-thirds vote

Pursuant to article IX, section 22,
Constitution of Arizona, this act is effective only on the affirmative vote of
at least two-thirds of the members of each house of the legislature and is
effective immediately on the signature of the governor or, if the governor
vetoes this act, on the subsequent affirmative vote of at least three-fourths
of the members of each house of the legislature.