HR5821-119

Introduced

To amend title XVIII of the Social Security Act to provide for the treatment of certain hospitals as critical access hospitals under the Medicare program.

119th Congress Introduced Oct 24, 2025

Analysis under review: This bill has generated analysis that may be too generic or incomplete. Clause-level evidence remains available below.

Summary

What This Bill Does

The bill creates an exemption allowing certain rural hospitals that were previously designated as Critical Access Hospitals (before 2002) to maintain CAH status despite not meeting the 35-mile location requirement, if they were. It relies on exemptions and definition changes. The main policy areas are Healthcare.

Who Benefits and How

Rural hospitals designated as CAH before January 1, 2002, that recently lost certification due to location requirements and were sole providers in their county could gain revenue opportunities and Rural communities served by these sole-provider hospitals could face reduced risk.

Who Bears the Burden and How

Centers for Medicare & Medicaid Services (CMS) would take on compliance duties.

Key Provisions

  • Creates an exemption allowing certain rural hospitals that were previously designated as Critical Access Hospitals (before 2002) to maintain CAH status despite not meeting the 35-mile location requirement, if they were...

Evidence Chain:

This summary is generated from the full bill text using AI analysis. Expand "Detailed Analysis" below for identified beneficiaries/burden bearers with clause-level evidence links.

At a Glance

What This Bill Does

The bill creates an exemption allowing certain rural hospitals that were previously designated as Critical Access Hospitals (before 2002) to maintain CAH status despite not meeting the 35-mile location requirement, if they were.

Key Policy Areas

Healthcare

Primary Purpose

The bill creates an exemption allowing certain rural hospitals that were previously designated as Critical Access Hospitals (before 2002) to maintain CAH status despite not meeting the 35-mile location requirement, if they were.

Policy Domains

Healthcare

Rural Hospital Fairness Act

Identified Gains
  • Rural hospitals designated as CAH before January 1, 2002, that recently lost certification due to location requirements and were sole providers in their county
  • Rural communities served by these sole-provider hospitals
Model: codex-gpt-5:bulk-repair | Version: bill_summary_v2 | Source: ih
Rural communities served by these sole-provider hospitals:
Rural hospitals designated as CAH before January 1, 2002, that recently lost certification due to location requirements and were sole providers in their county:
Identified Costs
  • Centers for Medicare & Medicaid Services (CMS)
Model: codex-gpt-5:bulk-repair | Version: bill_summary_v2 | Source: ih
Centers for Medicare & Medicaid Services (CMS):

Legislative Progress

Introduced
Introduced Committee Passed
Oct 24, 2025

Mr. LaMalfa introduced the following bill; which was referred to …

Stakeholder Effects

cui bono?

How this legislation distributes effects. Mention counts reflect frequency, not effect magnitude.

Healthcare
2 mentions across 1 clause
+2 positive

Rural hospitals designated as CAH before January 1, 2002, that recently lost certification due to location requirements and were sole providers in their county

Healthcare Beneficiaries
1 mention across 1 clause
+1 positive

Rural communities served by these sole-provider hospitals

Government
1 mention across 1 clause
-1 negative

Centers for Medicare & Medicaid Services

1/2
sections analyzed
Full impact breakdown

Bill Structure & Actor Mappings

Who is "The Secretary" in each section?

Domains
Healthcare
Actor Mappings
"the_state"
→ State government health agencies responsible for CAH designation
"the_secretary"
→ Secretary of Health and Human Services

Key Definitions

Terms defined in this bill

3 terms
"critical access hospital" §2

A rural hospital designation under Medicare that provides special reimbursement and regulatory flexibility, originally established under Section 1820 of the Social Security Act (42 U.S.C. 1395i-4)

"facility described in subparagraph (B)" §2_facility_described

A facility that: (i) was designated as a critical access hospital before January 1, 2002; (ii) as of December 31, 2024, was certified by the Secretary as a critical access hospital; and (iii) as of the date notified of loss of certification, was located in a county with no other hospital, critical access hospital, or rural emergency hospital

"location requirement under subsection (c)(2)(B)(i)(I)" §2_location_requirement

The statutory requirement that critical access hospitals must be located more than 35 miles from another hospital (or be certified by the State as a necessary provider)

We use a combination of our own taxonomy and classification in addition to large language models to assess meaning and potential beneficiaries. High confidence means strong textual evidence. Always verify with the original bill text.

Learn more about our methodology