H.R. 10729 — Long-Term Rural Health Investment Act of 2026

This section revises the cap on state directed payments under Medicaid managed care to 200 percent of the specified Medicare payment rate (or average commercial rate in the state) for rating periods beginning on or after January 1, 2030. It phases down certain payments approved before July 1, 2028, by 10 percent annually until they reach the new cap. It allows states to condition payments on historical utilization and to make separate payments outside the capitation rate beginning January 1, 2028. It requires states to submit detailed data on such payments through the Transformed Medicaid Statistical Information System beginning January 1, 2027.

This section restores the Medicaid provider tax rules under section 1903(w) of the Social Security Act to the status in effect before enactment of Public Law 119–21. It rescinds all amounts appropriated under section 71115(c) of that law.