PlainBillCongress, translated.Legislation. Context. Public interest.Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Congressional Research Service
No official summary is available in the imported record yet.
People & committees
Rep. Tokuda, Jill N. [D-HI-2] · D–HI
Legislative record
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Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Introduced in House
Introduced in House
Primary sources
Text links open the official source. We also preserved the text version used in the PlainBill explanation below.
Source last updated: Oct 8, 2026. Consult Congress.gov for the current record.
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PlainBill explanation
Based on the full Introduced in House · 2026-09-03 text. This explanation has not received human editorial review. This overview describes the proposal’s major provisions; it does not establish what its real-world effects would be.
This bill would change eligibility for rural emergency hospital designation and allow these hospitals to include additional inpatient and maternity care units. It would also raise payments for certain laboratory tests and let hospitals arrange to provide extended care of the kind offered by skilled nursing facilities. These proposals would affect participating hospitals and the patients receiving those services.
the Secretary shall promulgate regulations to waive the requirements under subparagraph (A) with respect to facilities that operate similarly to a rural emergency hospital in order for such facilities to be eligible for conversion to a rural emergency hospital
(C) maintain or include a unit of the facility that is a distinct part licensed as an inpatient psychiatric unit for behavioral health patients and allows for inpatient care; (D) maintain or include a unit of the facility that is a distinct part licensed as an inpatient rehabilitation facility and allows for inpatient care; and (E) maintain or include a unit of the facility that is a distinct part licensed as an obstetric wing, labor and delivery unit, or obstetric emergency department.
the amount of payment for such tests shall be equal to the amount of payment that would otherwise apply under the applicable fee schedule, increased by 5 percent
may enter into an agreement with the Secretary under which its facilities may be used for the furnishing of services of the type which, if furnished by a skilled nursing facility would constitute extended care services.
Section 1 would name the legislation the Rural Emergency Hospital Designation Improvement Act.
This Act may be cited as the Rural Emergency Hospital Designation Improvement Act.
Section 2 would replace the eligibility provision’s single-date wording, “as of,” with wording covering any point in a period beginning January 1, 2015. The amendment leaves the period’s ending date in the existing statute.
Section 1861(kkk)(3) of the Social Security Act (42 U.S.C. 1395x(kkk)(3)) is amended in the matter preceding subparagraph (A), by striking as of and inserting at any point during the period beginning on January 1, 2015, and ending on.
Section 2 would require the Secretary to issue regulations within one year after enactment of the new waiver provision. Those regulations would waive the referenced eligibility requirements for facilities that operate similarly to rural emergency hospitals, allowing them to qualify for conversion.
Not later than 1 year after the date of enactment of this subparagraph, the Secretary shall promulgate regulations to waive the requirements under subparagraph (A) with respect to facilities that operate similarly to a rural emergency hospital in order for such facilities to be eligible for conversion to a rural emergency hospital under this subsection.
Section 3 would add authority for rural emergency hospitals to maintain separately licensed units for inpatient psychiatric care, inpatient rehabilitation, and obstetric care, including labor and delivery or obstetric emergency departments.
(C) maintain or include a unit of the facility that is a distinct part licensed as an inpatient psychiatric unit for behavioral health patients and allows for inpatient care; (D) maintain or include a unit of the facility that is a distinct part licensed as an inpatient rehabilitation facility and allows for inpatient care; and (E) maintain or include a unit of the facility that is a distinct part licensed as an obstetric wing, labor and delivery unit, or obstetric emergency department.
Section 4 would increase payments by 5 percent above the applicable fee schedule—the schedule used to set payment amounts—for clinical and other diagnostic laboratory tests furnished by rural emergency hospitals on or after January 1, 2027. This would apply only to tests outside the referenced statutory category of covered outpatient department services.
In the case of clinical diagnostic laboratory tests and other diagnostic laboratory tests that are not covered OPD services (as defined in section 1833(t)(1)(B)) furnished by a rural emergency hospital (as defined in section 1861(kkk)(2)) on or after January 1, 2027, the amount of payment for such tests shall be equal to the amount of payment that would otherwise apply under the applicable fee schedule, increased by 5 percent
For those laboratory tests, any applicable patient copayment would be calculated as though the 5 percent payment increase had not occurred.
shall include the application of any copayment amount determined under this part as if such increase had not occurred
Section 5 would allow, but would not require, a rural emergency hospital to enter an agreement with the Secretary to provide extended care of the kind furnished by skilled nursing facilities. Payment under such an agreement would be based on reasonable costs determined through the referenced statutory method.
(F) may enter into an agreement with the Secretary under which its facilities may be used for the furnishing of services of the type which, if furnished by a skilled nursing facility would constitute extended care services. Payment to a rural emergency hospital for services furnished under such an agreement shall be based upon the reasonable cost of the services as determined under section 1883(a)(2)(B)
Section 6 would require the Secretary of Health and Human Services to issue regulations within one year after enactment allowing a rural emergency hospital returning to its previous critical access hospital designation to regain its former “necessary provider” status. Only facilities that held that status before converting to rural emergency hospitals could use this restoration provision.
Not later than 1 year after the date of the enactment of this Act, the Secretary of Health and Human Services shall promulgate regulations to permit a rural emergency hospital
that reverts back to its previous designation as a critical access hospital
to regain its status as a necessary provider of health care services pursuant to section 1820(c)(2)(B)(i)(II) of such Act (42 U.S.C. 1395i–4(c)(2)(B)(i)(II)), but only if the facility was designated as a necessary provider of health care services pursuant to such section prior to converting to a rural emergency hospital.
Section 7, addressing National Health Service Corps site eligibility, would require regulations treating rural emergency hospitals as health professional shortage areas—a designation concerning shortages of health workers. The Secretary of Health and Human Services would act through the Health Resources and Services Administration.
7. National Health Service Corps Site Eligibility The Secretary of Health and Human Services, acting through the Administrator of the Health Resources and Services Administration, shall promulgate regulations to deem a rural emergency hospital (as defined in section 1861(kkk)(2) of the Social Security Act (42 U.S.C. 1395x(kkk)(2))) to be a health professional shortage area in accordance with section 332(a)(1)(C) of the Public Health Service Act (42 U.S.C. 254e(a)(1)(C)).
Section 8 would add rural emergency hospitals to two provisions governing small rural hospital improvement program grants: one mentioning critical access hospitals and another mentioning small rural hospitals.
8. Small rural hospital improvement program grants Section 1820(g) of the Social Security Act (42 U.S.C. 42 U.S.C. 1395i–4(g)) is amended— (1) in paragraph (1)(D), by inserting or rural emergency hospitals (as defined in section 1861(kkk)(2)) after critical access hospitals; and (2) in paragraph (3)(A), by inserting or rural emergency hospitals (as defined in section 1861(kkk)(2)) after small rural hospitals.
Section 9 would expressly include rural emergency hospital services licensed or otherwise approved by the state in the referenced Medicaid services provision.
9. Inclusion of rural emergency hospital services under Medicaid (a) In general Section 1905(a) of the Social Security Act (42 U.S.C. 1396d(a)) is amended— (1) in paragraph (2)(A), by inserting (including rural emergency hospital services, as defined in section 1861(kkk)(1), which are licensed or otherwise approved by the State) after services
Section 9 would also add language expressly including services provided in a nursing facility that is a separate unit within a rural emergency hospital in another Medicaid services provision.
in paragraph (4)(A), by inserting but including services provided in a nursing facility that is a distinct part unit of a rural emergency hospital, as defined in section 1861(kkk)(2) after diseases.
Section 9 states that its amendments would apply to medical assistance provided on or after enactment, subject to the exception for states needing legislation. Its effective-date sentence refers specifically to amendments made by “this subsection.”
(b) Effective date (1) In general Subject to paragraph (2), the amendments made by this subsection shall apply with respect to medical assistance provided on or after the date of enactment of this Act.
If the Secretary determines that a state needs legislation to comply with section 9, its Medicaid plan would receive additional time without being treated as noncompliant solely for missing the new requirement. That protection would last until the first day of the first calendar quarter after the close of the first regular legislative session beginning after enactment. Each year of a two-year session would count separately.
In the case of a State plan under title XIX of the Social Security Act (42 U.S.C. 1396 et seq.) that the Secretary of Health and Human Services determines requires State legislation in order for such plan to meet any requirement imposed by the amendments made by this section, such plan shall not be regarded as failing to comply with the requirements of such title solely on the basis of its failure to meet such an additional requirement before the first day of the first calendar quarter beginning after the close of the first regular session of the State legislature that begins after the date of the enactment of this Act.
For purposes of the previous sentence, in the case of a State that has a 2-year legislative session, each year of the session shall be considered to be a separate regular session of the State legislature.
The supplied official-actions snapshot, updated October 8, 2026, records introduction in the House on September 3, 2026, and referral that day to the Energy and Commerce and Ways and Means committees.
Source snapshot updated 2026-10-08T18:21:20Z.
2026-09-03: Introduced in House
2026-09-03: Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
A closer look
Reviewed version: Introduced in House · 2026-09-03. These findings describe provisions and who may benefit; they are not judgments of waste, corruption, or motive.
This review covers the supplied bill text. “None identified” does not rule out provisions in later versions or accompanying reports and disclosures.
Provisions outside the bill’s main subject, or policy changes attached to appropriations.
None identified in the reviewed text
No unrelated provision or policy change attached to appropriations was identified in the complete supplied introduced text. This conclusion applies only to this version and does not establish what appears in other versions or accompanying materials.
Spending directed to particular recipients or places outside ordinary competitive or formula-based allocation.
None identified in the reviewed text
No congressionally directed spending for a particular recipient or place was identified in the complete supplied introduced text. This conclusion is limited to this version and does not establish formal earmark status in materials outside the bundle.
Narrow exceptions, exemptions, or preferential treatment that warrant a closer look.
Findings to examine
The supplied introduced text contains conditional eligibility relief and restoration of a prior regulatory status for defined groups of facilities. Both relate to the bill’s main policy; this classification makes no judgment about their merits or origins.
Facilities that operate similarly to rural emergency hospitals would receive an exemption from the referenced eligibility requirements through mandatory waiver regulations. This is an express eligibility exception supporting conversion, although the text does not define which facilities would qualify.
the Secretary shall promulgate regulations to waive the requirements under subparagraph (A) with respect to facilities that operate similarly to a rural emergency hospital in order for such facilities to be eligible for conversion to a rural emergency hospital under this subsection.
The proposed necessary-provider restoration provision would benefit a narrower group: rural emergency hospitals returning to their previous critical access hospital designation that held necessary-provider status before conversion. This would preserve access to a former status based on the facility’s designation history.
the Secretary of Health and Human Services shall promulgate regulations to permit a rural emergency hospital
that reverts back to its previous designation as a critical access hospital
to regain its status as a necessary provider of health care services pursuant to section 1820(c)(2)(B)(i)(II) of such Act (42 U.S.C. 1395i–4(c)(2)(B)(i)(II)), but only if the facility was designated as a necessary provider of health care services pursuant to such section prior to converting to a rural emergency hospital.
Full text preserved for this analysis. Legislative record snapshot: Oct 8, 2026. How PlainBill uses AI