The "Rural Hospital Investment Act of 2025" seeks to bolster the financial stability of rural hospitals in Alabama by creating the Rural Hospital Investment Program, which will be managed by the newly established Rural Hospital Investment Program Board. This board will oversee the distribution of state tax credits to incentivize donations to eligible rural hospitals, defined in the bill, which must meet specific criteria such as serving Medicare and Medicaid patients and submitting a five-year financial viability plan. The act includes provisions for the board's composition, which will include state representatives and members from the Alabama Hospital Association, and mandates the creation of an operations manual to assess hospitals based on their financial needs.

Additionally, the bill outlines a framework for tax credits related to donations, requiring third parties involved in fundraising to provide a list of eligible hospitals to potential donors. Starting in March 2027, rural hospitals must file annual reports detailing donations received and their intended use, while also reporting all donations to the Alabama Department of Revenue within 30 days. The legislation sets an initial cap of $20 million on tax credits for the 2026 tax year, increasing to $30 million in subsequent years, with specific limits on contributions to individual hospitals. The act emphasizes transparency and accountability in donation reporting and tax credit claims, taking effect immediately upon passage.