I 
118TH CONGRESS 
2D SESSION 
H. R. 7931 
To amend title XVIII of the Social Security Act to update the fee schedule 
for ambulance services provided by critical access hospitals. 
IN THE HOUSE OF REPRESENTATIVES 
APRIL 10, 2024 
Mrs. MILLER of West Virginia (for herself and Ms. CARAVEO) introduced the 
following bill; which was 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 consider-
ation of such provisions as fall within the jurisdiction of the committee 
concerned 
A BILL 
To amend title XVIII of the Social Security Act to update 
the fee schedule for ambulance services provided by crit-
ical access hospitals. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Preserving Emergency 
Access in Key Sites Act’’ or the ‘‘PEAKS Act’’. 
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SEC. 2. UPDATE TO FEE SCHEDULE FOR AMBULANCE SERV-
ICES PROVIDED BY CRITICAL ACCESS HOS-
PITALS. 
Section 1834(l)(8) of the Social Security Act (42 
U.S.C. 1395m(l)(8)) is amended in the flush left text fol-
lowing subparagraph (B) by inserting ‘‘(or, in the case of 
mountainous terrain or in areas with only secondary roads 
available, a 15-mile drive)’’ after ‘‘35-mile drive’’. 
SEC. 3. TREATMENT OF HOSPITALS THAT MET MOUN-
TAINOUS TERRAIN OR SECONDARY ROADS 
DISTANCE REQUIREMENT FOR DESIGNATION 
AS CRITICAL ACCESS HOSPITAL. 
Section 1820(h) of the Social Security Act (42 U.S.C. 
1395i–4(h)) is amended by adding at the end the following 
new paragraph: 
‘‘(4) TREATMENT
OF
HOSPITALS
THAT
MET 
MOUNTAINOUS TERRAIN OR SECONDARY ROADS DIS-
TANCE REQUIREMENTS FOR DESIGNATION.— 
‘‘(A) IN GENERAL.—Beginning January 1, 
2025, in the case of a hospital described in sub-
paragraph (B), such hospital shall be deemed to 
meet the 15-mile distance requirement for 
mountainous terrain or secondary roads de-
scribed in subsection (c)(2)(B)(i)(I). 
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‘‘(B) HOSPITAL
DESCRIBED.—A hospital 
described in this subparagraph is a hospital 
that— 
‘‘(i) as of the date of enactment of 
this paragraph, is designated as a critical 
access hospital; 
‘‘(ii) demonstrates (in a manner deter-
mined by the Secretary) that the hospital 
met the 15-mile distance requirement for 
mountainous terrain or secondary roads 
described in subsection (c)(2)(B)(i)(I) as of 
the hospital’s last certification as a critical 
access hospital; and 
‘‘(iii) after such date of enactment, 
has a new hospital or other facility de-
scribed in this subsection that is located 
not less than 10, but no more than 15, 
miles from the hospital. 
‘‘(C) REGULATIONS.—Not later than 1 
year after the date of enactment of this para-
graph, the Secretary shall promulgate regula-
tions to carry out this paragraph.’’. 
Æ 
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