Sponsor
Doug Lamalfa
Representative · R-CA
Deems certain long-standing rural facilities to have been Medicare-certified CAHs if they meet specific date and single-hospital-county conditions, preserving certification while they remain eligible.
Representative · R-CA
The bill helps keep small rural hospitals open and preserves local access to care by restoring CAH treatment for qualifying facilities, but it raises the risk of higher Medicare/taxpayer costs, added state administrative burden, and potential payment to facilities that may not meet current quality or access standards.
People in affected rural counties (including patients with chronic conditions) retain local access to emergency and inpatient care because facilities that lost CAH certification but meet the criteria will be treated as certified.
Rural hospitals and health systems keep access to Medicare Critical Access Hospital (CAH) reimbursements, stabilizing facility revenue and helping preserve services and staffing.
Maintaining CAH payment eligibility reduces the chance of service reductions or closures in small rural hospitals by improving their short-term financial stability.
Facilities that do not truly meet current access or quality standards could receive preferential payment if the Secretary’s criteria are not strictly enforced, potentially compromising care quality.
Taxpayers and the Medicare program may face higher costs if more facilities receive CAH reimbursements retroactively or on an ongoing basis.
States may face additional administrative and coordination burdens to maintain designation eligibility and work with HHS on deemed certifications.
Based on analysis of 2 sections of legislative text.
Official title: To amend title XVIII of the Social Security Act to provide for the treatment of certain hospitals as critical access hospitals under the Medicare program.
Introduced October 24, 2025 by Doug Lamalfa · Last progress October 24, 2025
Makes certain small rural hospitals that lost formal Medicare critical access hospital (CAH) certification eligible to be treated as if they were certified for legal purposes, provided they meet specific date and location conditions and still qualify for state designation and any Secretary criteria. The change only affects facilities that were CAHs before 2002, were certified as CAHs by the Secretary on December 31, 2024, and at the time they lost certification were the only hospital-type facility in their county (or equivalent).