Second Chances for Rural Hospitals Act
The Second Chances for Rural Hospitals Act would expand the Medicare definition of Rural Emergency Hospitals (REHs) and create a pathway for certain rural hospitals that previously closed to re-enter the REH program. Specifically, it adds a new category of facilities that, between 2014 and 2020, were either critical access hospitals (CAHs) or subsection (d) hospitals in rural areas and have since ceased operations, to be eligible for REH designation if they enroll under Medicare's REH program. The bill also adjusts how REHs are paid when they are located near other hospitals, CAHs, or REHs, and it sets an effective date of January 1, 2027. The overarching goal is to give “second chances” to rural hospitals to restore emergency services and access to care in rural communities.
Key Points
- 1Expands REH eligibility: Adds facilities that, during January 1, 2014 through December 26, 2020, were CAHs or subsection (d) hospitals in rural areas and, as of enactment, had ceased operations, to the roster of facilities that can enroll as REHs under 1866(j).
- 2Enrollment pathway: These previously closed rural facilities would be able to enroll under 1866(j) to become REHs and participate in REH payment systems.
- 3Payment rule adjustments: Makes targeted changes to Medicare payment rules for REHs that are near other hospitals, CAHs, or REHs to prevent unintended payment effects:
- 4- If a facility described in the new 1861(kkk)(3)(B) category is within 35 miles of the nearest hospital/CAH/REH, certain payment increases would not apply.
- 5- There are additional carve-outs related to proximity (e.g., within 10 miles) that modify how payments apply to such facilities.
- 6Effective date: Applies to the amendments beginning January 1, 2027, giving time for implementation and readiness.