This bill allows states to designate rural hospitals as critical access hospitals without mileage limitations, enhancing healthcare access in rural areas. It also applies retroactively to redesignations made before the bill's enactment.
Mark Green
Representative
TN-7
The "Rural Health Care Access Act of 2025" amends the Social Security Act to allow states to designate rural facilities as critical access hospitals without mileage limitations. This change broadens access to essential healthcare services in rural areas by removing previous mileage restrictions for hospital designation. The amendments apply to hospital designations or redesignations made on or after the enactment of this act, including any redesignations made before the enactment.
Rural Health Care Access Act of 2025 Eliminates Mileage Rules for Critical Access Hospitals
The Rural Health Care Access Act of 2025 amends the Social Security Act to boost healthcare access in rural communities. Specifically, it removes mileage restrictions that previously limited which rural facilities could be designated as "critical access hospitals" (CAHs) under Medicare's Rural Hospital Flexibility Program. This designation is crucial because CAHs receive cost-based reimbursement from Medicare, which can be a financial lifeline for hospitals operating in sparsely populated areas.
Unpacking the Changes
The core change is the removal of specific mileage-related clauses from Section 1820(c)(2)(B)(i)(A) of the Social Security Act. The bill strikes subclauses (I) and (II), which imposed distance requirements for CAH designation. Essentially, this means that a State can now designate any qualifying rural facility as a CAH, regardless of its distance from other hospitals. The Act also clarifies, in Section 1820(h)(3), that any redesignations made before this law are still valid. These changes apply to designations made on or after the Act's enactment date.
Real-World Impact
Imagine a small rural hospital struggling to stay afloat because it's just a few miles too close to a larger facility, disqualifying it from CAH status under the old rules. This Act could be the difference between that hospital staying open or closing its doors. For a farmer who relies on that hospital for emergency care, or an elderly resident who needs regular check-ups, this change could mean continued access to local healthcare. Easier access to care has a positive effect on health outcomes. For hospital administrators, the cost-based reimbursement that comes with CAH designation provides the needed financial support to continue operations.
Potential Snags
While the aim is to help truly isolated hospitals, there's a chance that facilities in less remote areas might now try to qualify as CAHs. This could potentially stretch resources, making it vital for state authorities to carefully evaluate applications and ensure they align with the spirit of the law, which is to support healthcare in truly underserved rural communities. The Act doesn't define any new criteria beyond removing the mileage limits, leaving the existing state-level designation process in place.