PEAKS Act

This bill aims to help rural hospitals and the people they serve. It updates how Medicare pays for ambulance rides provided by critical access hospitals, which are small, rural hospitals that keep emergency care close to home. The goal is to better support these hospitals so they can keep ambulances running and respond quickly when people need help.

It also protects some hospitals’ rural status when nearby facilities open. Starting January 1, 2026, if a hospital already counted as “critical access” had met the special 15-mile rule for mountainous terrain or secondary roads, it will still be treated as meeting that distance rule even if a new hospital or facility later opens 10 to 15 miles away. The federal agency must issue rules to carry this out within a year of the law’s enactment.

Key points

• Who is affected: Medicare patients who need ambulance services, and rural “critical access” hospitals that provide them.
• What changes: Medicare’s pay rates for ambulance services from these hospitals are updated; certain hospitals keep meeting the 15-mile distance test if a new facility opens 10–15 miles away .
• When: The distance rule protection starts January 1, 2026; rules must be issued within one year of enactment.