Sponsors (2)
The bill broadens eligibility for Rural Emergency Hospital status to preserve emergency access and financial stability for rural facilities, but it raises Medicare costs and risks reducing local inpatient services and competitive balance among hospitals.
Rural hospitals and former off-campus emergency departments can more easily qualify as Rural Emergency Hospitals (REHs) and receive continued Medicare payments and related financial support due to the clarified timing rule.
People living in rural counties are more likely to retain local emergency services because more facilities may convert to REHs instead of closing, preserving nearby emergency access.
Residents and taxpayers face higher Medicare spending because expanding REH eligibility will likely increase Medicare outlays to support more facilities.
Some rural communities may lose access to full inpatient hospital services if more off-campus EDs convert to REHs, which provide emergency and outpatient care but not full inpatient services.
Hospitals that choose not to convert to REH status could face competitive pressure and patient volume shifts if nearby facilities obtain REH payments and advantages.
Based on analysis of 2 sections of legislative text.
Adds certain former hospital off‑campus outpatient departments that were dedicated emergency departments in rural counties to the REH eligibility list and clarifies the eligibility timing window.
Official title: To amend title XVIII of the Social Security Act to adjust the eligibility for the rural emergency hospital designation under the Medicare program.
Introduced December 10, 2025 by Derek Schmidt · Last progress December 10, 2025
Expands which facilities can qualify as Rural Emergency Hospitals (REHs) by adding certain former hospital off‑campus outpatient departments that operated as dedicated emergency departments in rural counties, and clarifies that eligibility can be satisfied if the facility met the test at any point between January 1, 2015 and the existing deadline. The change broadens the pool of facilities eligible for REH designation, potentially preserving emergency access in rural areas and allowing more sites to receive REH status and associated Medicare payment rules.