IB 

Union Calendar No. 806 

118TH CONGRESS 

2D SESSION H. R. 8246 

[Report No. 118–957] 

To amend title XVIII of the Social Security Act to modify the criteria 

for designation of rural emergency hospitals. 

IN THE HOUSE OF REPRESENTATIVES 

MAY 6, 2024 

Mr. ARRINGTON introduced the following bill; which was referred to the 

Committee on Ways and Means 

DECEMBER 27, 2024 

Additional sponsors: Ms. TOKUDA and Mr. ROSE

DECEMBER 27, 2024 

Reported with an amendment, committed to the Committee of the Whole 

House on the State of the Union, and ordered to be printed 

[Strike out all after the enacting clause and insert the part printed in italic] 

[For text of introduced bill, see copy of bill as introduced on May 6, 2024] 


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•HR 8246 RH

A BILL 

To amend title XVIII of the Social Security Act to modify 

the criteria for designation of rural emergency hospitals. 


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•HR 8246 RH

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Second Chances for 

5 Rural Hospitals Act’’. 

6 SEC. 2. EXPANDING THE DEFINITION OF RURAL EMER7 GENCY HOSPITAL UNDER THE MEDICARE 

8 PROGRAM. 

9 (a) IN GENERAL.—Section 1861(kkk) of the Social Se10 curity Act (42 U.S.C. 1395x(kkk)) is amended— 

11 (1) in paragraph (2)(A), by striking ‘‘is enrolled 

12 under section 1866(j)’’ and inserting ‘‘except in the 

13 case of a facility described in paragraph (3)(B)’’; 

14 (2) in paragraph (3)— 

15 (A) in subparagraph (B), by striking the 

16 period at the end and inserting ‘‘; or’’; 

17 (B) by redesignating subparagraphs (A) 

18 and (B) as clauses (i) and (ii), respectively, and 

19 adjusting the margins accordingly; 

20 (C) by striking ‘‘facility that as of’’ and in21 serting ‘‘facility— 

22 ‘‘(A) that as of’’; and 

23 (D) by adding at the end the following new 

24 subparagraph: 

25 ‘‘(B) that— 


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•HR 8246 RH

1 ‘‘(i) during the period beginning Janu2 ary 1, 2014, and ending December 26, 

3 2020— 

4 ‘‘(I) was a critical access hospital; 

5 or 

6 ‘‘(II) was a subsection (d) hos7 pital (as defined in section 

8 1886(d)(1)(B)) located in a county (or 

9 equivalent unit of local government) in 

10 a rural area (as defined in section 

11 1886(d)(2)(D)); and 

12 ‘‘(ii) as of the date of the enactment of 

13 this subparagraph, had ceased operations.’’; 

14 and 

15 (3) in paragraph (4)— 

16 (A) in subparagraph (A)(i), by striking 

17 ‘‘An action plan’’ and inserting ‘‘Except in the 

18 case of a facility described in paragraph (3)(B), 

19 an action plan’’; and 

20 (B) in subparagraph (B)(i), by inserting 

21 ‘‘except in the case of a facility described in 

22 paragraph (3)(B),’’ before ‘‘the facility’’. 

23 (b) AMENDMENTS TO PAYMENT RULES.—Section 

24 1834(x) of the Social Security Act (42 U.S.C. 1395m(x)) 

25 is amended— 


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•HR 8246 RH

1 (1) in paragraph (1), by inserting ‘‘, except that, 

2 in the case of a facility described in section 

3 1861(kkk)(3)(B) that, as of the date on which such fa4 cility submits an application under section 1866(j) to 

5 enroll under this title as a rural emergency hospital, 

6 is located less than 35 miles away from the nearest 

7 hospital, critical access hospital, or rural emergency 

8 hospital, such increase shall not apply’’ before the pe9 riod at the end; and 

10 (2) in paragraph (2)(A), by inserting ‘‘(other 

11 than a facility described in section 1861(kkk)(3)(B) 

12 that, as of the date on which such facility submits an 

13 application under section 1866(j) to enroll under this 

14 title as a rural emergency hospital, is located less 

15 than 10 miles away from the nearest hospital, critical 

16 access hospital, or rural emergency hospital)’’ after 

17 ‘‘rural emergency hospital’’. 

18 (c) EFFECTIVE DATE.—The amendments made by this 

19 section shall apply beginning January 1, 2027. 


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Union Calendar No. 806 

118TH CONGRESS 

2D SESSION H. R. 8246 

[Report No. 118–957] 

A BILL 

To amend title XVIII of the Social Security Act to 

gency hospitals. modify the criteria for designation of rural emerDECEMBER 27, 2024 

Reported with an amendment, committed to the Comand ordered to be printed mittee of the Whole House on the State of the Union, 


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