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Second Chances for Rural Hospitals Act This bill allows additional hospitals to qualify as rural emergency hospitals (REHs) under Medicare. In 2020, Congress established REHs as a new Medicare provider designation for hospitals in rural areas providing emergency department services, observation care, and other outpatient medical and health services for which the annual per patient average length of stay does not exceed 24 hours. These hospitals must have been open as of December 27, 2020, in order to qualify for the new REH designation. The bill allows hospitals that were open between January 1, 2014, and December 26, 2020, to also qualify for the REH designation, and it provides for a specific payment structure for these hospitals. The bill's changes take effect beginning in 2027.
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Full Bill Text
119 HR 1775 IH: Second Chances for Rural Hospitals Act U.S. House of Representatives 2025-03-03 text/xml EN Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain. I 119th CONGRESS 1st Session H. R. 1775 IN THE HOUSE OF REPRESENTATIVES March 3, 2025 Mr. Arrington (for himself, Ms. Tokuda , and Mr. Pfluger ) introduced the following bill; which was referred to the Committee on Ways and Means , and in addition to the Committee on Energy and Commerce , for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned A BILL To amend title XVIII of the Social Security Act to modify the criteria for designation of rural emergency hospitals. 1. Short title This Act may be cited as the Second Chances for Rural Hospitals Act . 2. Expanding the definition of rural emergency hospital under the Medicare program (a) In general Section 1861(kkk) of the Social Security Act ( 42 U.S.C. 1395x(kkk) ) is amended— (1) in paragraph (2)(A), by striking is enrolled under section 1866(j) and inserting except in the case of a facility described in paragraph (3)(B) ; (2) in paragraph (3)— (A) in subparagraph (B), by striking the period at the end and inserting ; or ; (B) by redesignating subparagraphs (A) and (B) as clauses (i) and (ii), respectively, and adjusting the margins accordingly; (C) by striking facility that as of and inserting facility— (A) that as of ; and (D) by adding at the end the following new subparagraph: (B) that— (i) during the period beginning January 1, 2014, and ending December 26, 2020— (I) was a critical access hospital; or (II) was a subsection (d) hospital (as defined in section 1886(d)(1)(B)) located in a county (or equivalent unit of local government) in a rural area (as defined in section 1886(d)(2)(D)); and (ii) as of the date of the enactment of this subparagraph, had ceased operations. ; and (3) in paragraph (4)— (A) in subparagraph (A)(i), by striking An action plan and inserting Except in the case of a facility described in paragraph (3)(B), an action plan ; and (B) in subparagraph (B)(i), by inserting except in the case of a facility described in paragraph (3)(B), before the facility . (b) Amendments to payment rules Section 1834(x) of the Social Security Act ( 42 U.S.C. 1395m(x) ) is amended— (1) in paragraph (1), by inserting , except that, in the case of a facility described in section 1861(kkk)(3)(B) that, as of the date on which such facility submits an application under section 1866(j) to enroll under this title as a rural emergency hospital, is located less than 35 miles away from the nearest hospital, critical access hospital, or rural emergency hospital, such increase shall not apply before the period at the end; and (2) in paragraph (2)(A), by inserting (other than a facility described in section 1861(kkk)(3)(B) that, as of the date on which such facility submits an application under section 1866(j) to enroll under this title as a rural emergency hospital, is located less than 10 miles away from the nearest hospital, critical access hospital, or rural emergency hospital) after rural emergency hospital . (c) Effective date The amendments made by this section shall apply beginning January 1, 2027.
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