Sponsors
The bill protects Medicare support and local access to care for eligible rural hospitals and patients, at the cost of increased Medicare/taxpayer spending, potential risk if standards are not strictly enforced, and added state administrative work.
Rural hospitals that previously lost Critical Access Hospital (CAH) certification but meet the Secretary's criteria will be treated as certified, preserving their Medicare CAH payment eligibility and stabilizing hospital revenue to support staffing and service continuity.
Patients in affected rural counties will retain local access to emergency and inpatient services supported by CAH designation, reducing travel time and preserving timely care.
Taxpayers and the Medicare program may face higher costs if more facilities receive CAH reimbursements retroactively or on an ongoing basis.
Patients could be exposed to lower-quality or insufficiently accessible care if facilities that do not meet current access or quality standards receive preferential CAH payment because enforcement of Secretary criteria is lax.
State governments may incur additional administrative burden to maintain designation eligibility and to coordinate with HHS on deemed certifications.
Based on analysis of 2 sections of legislative text.
Deems certain formerly certified critical access hospitals (designated before 2002 and certified as of Dec 31, 2024) to be certified under Medicare so long as they remain eligible and meet Secretary criteria.
Deems certain formerly certified critical access hospitals (CAHs) to be treated as having been certified under the Medicare CAH rules so long as they remain otherwise eligible for State designation and meet any applicable Secretary criteria. The deeming applies only to facilities that were designated as CAHs before January 1, 2002, were certified as CAHs by the Secretary as of December 31, 2024, and, when notified of loss of certification, were located in a county (or equivalent) that had no other hospital, CAH, or rural emergency hospital. The change restores federal CAH certification status for a narrow set of rural hospitals and is conditional on continued eligibility under State designation rules and Secretary criteria; it does not create new funding or broader program changes.
Introduced October 24, 2025 by Doug Lamalfa · Last progress October 24, 2025