The main purpose of this legislation is to update certain rules regarding physician-owned hospitals under the Social Security Act. The goal is to improve access to quality healthcare in rural areas by revising self-referral exemptions that currently limit how these hospitals operate. Key provisions of the legislation include defining what constitutes a "covered rural hospital" and allowing for the expansion of existing physician-owned hospitals. A covered rural hospital is defined as one located in a rural area that meets specific criteria when it enrolls under Medicare.