PEAKS Act

The PEAKS Act (Preserving Emergency Access in Key Sites Act) would adjust Medicare rules governing ambulance services provided by critical access hospitals (CAHs). Specifically, it changes the distance standard used to determine eligibility and reimbursement for certain ambulance services in areas with mountainous terrain or limited road access by replacing a 35-mile drive requirement with a 15-mile drive in those difficult terrains. It also adds a transition provision: starting January 1, 2026, hospitals that previously met the mountainous/secondary-road distance requirement and are CAHs will be deemed to meet the new 15-mile standard, and if a nearby new hospital or facility opens within 10 to 15 miles of the CAH, the CAH’s designation can be preserved. The bill requires the secretary to issue regulations within one year to implement these changes. In short, the bill aims to maintain and improve emergency access in rural, hard-to-reach areas by adjusting the distance thresholds used for CAH ambulance payments and designation, with a phased implementation and regulatory guidance.