I 
119TH CONGRESS 
1ST SESSION H. R. 1775 
To amend title XVIII of the Social Security Act to modify the criteria 
for designation of rural emergency hospitals. 
IN THE HOUSE OF REPRESENTATIVES 
MARCH 3, 2025 
Mr. ARRINGTON (for himself, Ms. TOKUDA, and Mr. PFLUGER) 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 modify 
the criteria for designation of rural emergency 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 ‘‘Second Chances for 
Rural Hospitals Act’’. 
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SEC. 2. EXPANDING THE DEFINITION OF RURAL EMER-
GENCY HOSPITAL UNDER THE MEDICARE 
PROGRAM. 
(a) IN GENERAL.—Section 1861(kkk) of the Social 
Security Act (42 U.S.C. 1395x(kkk)) is amended— 
(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)’’; 
(2) in paragraph (3)— 
(A) in subparagraph (B), by striking the 
period at the end and inserting ‘‘; or’’; 
(B) by redesignating subparagraphs (A) 
and (B) as clauses (i) and (ii), respectively, and 
adjusting the margins accordingly; 
(C) by striking ‘‘facility that as of’’ and in-
serting ‘‘facility— 
‘‘(A) that as of’’; and 
(D) by adding at the end the following new 
subparagraph: 
‘‘(B) that— 
‘‘(i) during the period beginning Jan-
uary 1, 2014, and ending December 26, 
2020— 
‘‘(I) was a critical access hos-
pital; or 
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‘‘(II) was a subsection (d) hos-
pital 
(as 
defined 
in 
section 
1886(d)(1)(B)) located in a county 
(or equivalent unit of local govern-
ment) 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 oper-
ations.’’; and 
(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’’. 
(b) AMENDMENTS
TO PAYMENT RULES.—Section 
1834(x) of the Social Security Act (42 U.S.C. 1395m(x)) 
is amended— 
(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 hos-
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pital, 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; and 
(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 hos-
pital)’’ after ‘‘rural emergency hospital’’. 
(c) EFFECTIVE DATE.—The amendments made by 
this section shall apply beginning January 1, 2027. 
Æ 
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