Official Summaries

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.

Current Full Text

[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 1775 Introduced in House (IH)]

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119th CONGRESS
  1st Session
                                H. R. 1775

To amend title XVIII of the Social Security Act to modify the criteria 
             for designation of rural emergency hospitals.


_______________________________________________________________________


                    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.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Second Chances for Rural Hospitals 
Act''.

SEC. 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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