The PEAKS Act aims to preserve emergency access in rural areas by protecting certain Critical Access Hospitals (CAHs) from losing their designation when a new hospital or facility opens nearby, and by adjusting ambulance distance rules for CAHs. Specifically, it provides a mechanism to treat hospitals that previously met the mountainous terrain or secondary-roads distance requirement as still meeting the 15-mile distance standard for CAH designation after January 1, 2026, under certain conditions. It also relaxes the distance standard for ambulance services furnished by CAHs in mountainous terrain or areas with only secondary roads, allowing a 15-mile drive (instead of the current 35-mile drive) for services beginning in 2026. The bill is titled the Preserving Emergency Access in Key Sites Act (PEAKS Act) and was introduced in the Senate in June 2025.