Bill Details
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This bill would change Medicare rules for certain small rural hospitals called critical access hospitals. Right now, a doctor must certify that an inpatient stay is expected to last no more than 96 hours for these services to be covered in a certain way. The bill would remove that 96-hour certification requirement, which could make it easier for these hospitals and their patients to get care without extra paperwork.
- The change applies to inpatient services at critical access hospitals under Medicare.
- The bill would delete the current rule that requires a physician to certify a 96-hour limit for these inpatient stays.
- If passed, the new rule would take effect for services provided on or after January 1, 2026.
Official Summaries
Critical Access Hospital Relief Act of 2025
This bill repeals the 96-hour physician-certification requirement for inpatient critical access hospital services under Medicare. Under current law, as a condition for Medicare payment for such services, a physician must certify that a patient may reasonably be expected to be discharged or transferred to a hospital within 96 hours after admission to the critical access hospital.
Current Full Text
[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 538 Introduced in House (IH)]
<DOC>
119th CONGRESS
1st Session
H. R. 538
To amend title XVIII of the Social Security Act to remove the 96-hour
physician certification requirement for inpatient critical access
hospital services.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
January 16, 2025
Mr. Smith of Nebraska (for himself and Ms. Sewell) introduced the
following bill; which was referred to the Committee on Ways and Means
_______________________________________________________________________
A BILL
To amend title XVIII of the Social Security Act to remove the 96-hour
physician certification requirement for inpatient critical access
hospital services.
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 ``Critical Access Hospital Relief Act
of 2025''.
SEC. 2. REMOVING MEDICARE 96-HOUR PHYSICIAN CERTIFICATION REQUIREMENT
FOR INPATIENT CRITICAL ACCESS HOSPITAL SERVICES.
(a) In General.--Section 1814(a) of the Social Security Act (42
U.S.C. 1395f(a)) is amended--
(1) in paragraph (6), by adding ``and'' at the end;
(2) in paragraph (7), at the end of subparagraph (E), by
striking ``; and'' and inserting a period; and
(3) by striking paragraph (8).
(b) Application.--The amendments made by subsection (a) shall apply
with respect to items and services furnished on or after January 1,
2026.
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