PlainBillCongress, translated.Legislation. Context. Public interest.Referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, 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
Version 00 · Introduced in House · Mar 3, 2025
Second Chances for Rural Hospitals Act
This bill allows additional hospitals to qualify as rural emergency hospitals (REHs) under Medicare.
In 2020, Congress established REHs as a new Medicare provider designation for hospitals in rural areas providing emergency department services, observation care, and other outpatient medical and health services for which the annual per patient average length of stay does not exceed 24 hours. These hospitals must have been open as of December 27, 2020, in order to qualify for the new REH designation.
The bill allows hospitals that were open between January 1, 2014, and December 26, 2020, to also qualify for the REH designation, and it provides for a specific payment structure for these hospitals. The bill's changes take effect beginning in 2027.
People & committees
Rep. Arrington, Jodey C. [R-TX-19] · R–TX
Legislative record
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Referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, 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 Ways and Means, and in addition to the Committee on Energy and Commerce, 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.
No related bills are listed in this snapshot. This does not establish whether the proposal has appeared in earlier Congresses.
Source last updated: Mar 17, 2026. Consult Congress.gov for the current record.
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PlainBill explanation
Based on the full Introduced in House · 2025-03-03 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.
The proposed Second Chances for Rural Hospitals Act would let certain closed hospitals qualify as rural emergency hospitals under Medicare. It would cover facilities that operated in specified hospital categories during 2014–2020 and had closed by enactment, with exceptions to some existing requirements. These facilities would face payment restrictions based on their distance from another hospital. The changes would apply beginning January 1, 2027.
This Act may be cited as the Second Chances for Rural Hospitals Act.
(B) that— (i) during the period beginning January 1, 2014, and ending December 26, 2020— (I) was a critical access hospital; or (II) was a subsection (d) hospital (as defined in section 1886(d)(1)(B)) located in a county (or equivalent unit of local government) in a rural area (as defined in section 1886(d)(2)(D)); and (ii) as of the date of the enactment of this subparagraph, had ceased operations.
Except in the case of a facility described in paragraph (3)(B), an action plan
is located less than 35 miles away from the nearest hospital, critical access hospital, or rural emergency hospital, such increase shall not apply
(other than a facility described in section 1861(kkk)(3)(B) that, as of the date on which such facility submits an application under section 1866(j) to enroll under this title as a rural emergency hospital, is located less than 10 miles away from the nearest hospital, critical access hospital, or rural emergency hospital)
The amendments made by this section shall apply beginning January 1, 2027.
The bill would add an eligibility route for facilities that had ceased operations by enactment. During January 1, 2014, through December 26, 2020, they must have been either a critical access hospital—a statutory hospital category—or a hospital in the separately defined “subsection (d)” category located in a rural county or equivalent local area. The referenced definitions are not supplied.
(B) that— (i) during the period beginning January 1, 2014, and ending December 26, 2020— (I) was a critical access hospital; or (II) was a subsection (d) hospital (as defined in section 1886(d)(1)(B)) located in a county (or equivalent unit of local government) in a rural area (as defined in section 1886(d)(2)(D)); and (ii) as of the date of the enactment of this subparagraph, had ceased operations.
For the rural emergency hospital definition, the bill would replace the words “is enrolled under section 1866(j)” with an exception for the newly eligible closed facilities. Because the surrounding existing provision is not reproduced, this textual change does not establish a blanket exemption from Medicare enrollment requirements.
(1) in paragraph (2)(A), by striking is enrolled under section 1866(j) and inserting except in the case of a facility described in paragraph (3)(B)
The newly eligible closed facilities would receive exceptions in two existing provisions: one concerning an action plan and another in section 1861(kkk)(4)(B)(i). The bill does not reproduce the full requirements, so the precise obligations removed cannot be fully described from this source.
(3) in paragraph (4)— (A) in subparagraph (A)(i), by striking An action plan and inserting Except in the case of a facility described in paragraph (3)(B), an action plan; and (B) in subparagraph (B)(i), by inserting except in the case of a facility described in paragraph (3)(B), before the facility.
A newly eligible closed facility would not receive the payment increase referenced in section 1834(x)(1) if it were less than 35 miles from the nearest hospital, critical access hospital, or rural emergency hospital when it applied to enroll as a rural emergency hospital. The source does not state the increase's amount.
(1) in paragraph (1), by inserting , except that, in the case of a facility described in section 1861(kkk)(3)(B) that, as of the date on which such facility submits an application under section 1866(j) to enroll under this title as a rural emergency hospital, is located less than 35 miles away from the nearest hospital, critical access hospital, or rural emergency hospital, such increase shall not apply before the period at the end
A separate payment restriction would exclude a newly eligible closed facility from section 1834(x)(2)(A) if it were less than 10 miles from the nearest hospital, critical access hospital, or rural emergency hospital when it applied to enroll. The existing payment provision is not reproduced, so its payment type and amount cannot be established here.
(2) in paragraph (2)(A), by inserting (other than a facility described in section 1861(kkk)(3)(B) that, as of the date on which such facility submits an application under section 1866(j) to enroll under this title as a rural emergency hospital, is located less than 10 miles away from the nearest hospital, critical access hospital, or rural emergency hospital) after rural emergency hospital.
The proposed eligibility, requirement, and payment changes would apply beginning January 1, 2027.
(c) Effective date The amendments made by this section shall apply beginning January 1, 2027.
The supplied official-actions snapshot, updated March 17, 2026, records introduction in the House on March 3, 2025, and referral that day to the Ways and Means and Energy and Commerce committees. It supplies no later action and does not establish whether the bill subsequently advanced or became law.
Source snapshot updated 2026-03-17T08:05:48Z.
2025-03-03: Introduced in House
2025-03-03: Referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, 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 · 2025-03-03. 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 is limited to that 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 particular recipients or places was identified in the complete supplied introduced text. This conclusion is limited to that version; the source set does not establish formal earmark status in accompanying materials.
Narrow exceptions, exemptions, or preferential treatment that warrant a closer look.
Findings to examine
The supplied text contains express exceptions for a narrowly defined group within the bill's main policy. Classification as a targeted benefit does not establish that the exceptions are improper.
Facilities that operated in the specified hospital categories during January 1, 2014, through December 26, 2020, and had ceased operations by enactment would receive special exceptions in the existing action-plan provision and section 1861(kkk)(4)(B)(i). These exceptions support the bill's expanded eligibility policy. Their full scope is uncertain because the underlying requirements are not reproduced.
(B) that— (i) during the period beginning January 1, 2014, and ending December 26, 2020— (I) was a critical access hospital; or (II) was a subsection (d) hospital (as defined in section 1886(d)(1)(B)) located in a county (or equivalent unit of local government) in a rural area (as defined in section 1886(d)(2)(D)); and (ii) as of the date of the enactment of this subparagraph, had ceased operations.
(3) in paragraph (4)— (A) in subparagraph (A)(i), by striking An action plan and inserting Except in the case of a facility described in paragraph (3)(B), an action plan; and (B) in subparagraph (B)(i), by inserting except in the case of a facility described in paragraph (3)(B), before the facility.
Full text preserved for this analysis. Legislative record snapshot: Mar 17, 2026. How PlainBill uses AI