The "Rural Hospital Investment Act of 2025" aims 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 encourage donations to eligible rural hospitals, defined in the act, which must meet specific criteria such as serving Medicare and Medicaid patients and submitting a five-year financial viability plan. The act also outlines the roles of board members, including representatives from the state government and the Alabama Hospital Association, and emphasizes the importance of local financial support for hospitals to qualify for the program.

Additionally, the bill establishes a framework for tax credits related to donations made to these hospitals, requiring third parties involved in donation management to provide potential donors with a list of eligible hospitals. Starting in March 2027, eligible hospitals must submit annual reports detailing donations received and their intended uses. The act sets a statewide annual cap on tax credits beginning at $20 million for the 2026 tax year, with provisions for increasing this limit in subsequent years. The Department of Revenue is tasked with implementing the act's rules, ensuring that tax credits do not impact the Alabama Special Mental Health Fund, and facilitating the issuance of these credits, which will be available starting January 1, 2026.