IB Union Calendar No. 806 118th CONGRESS 2d Session H. R. 8246 [Report No. 118–957] 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 A BILL To amend title XVIII of the Social Security Act to modify the criteria for designation of rural emergency hospitals.

1. Short title This Act may be cited as the Second Chances for Rural Hospitals Act . 2. Expanding the definition of rural emergency 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 inserting facility— (A) that as of ; and (D) by adding at the end the following new subparagraph: (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. ; 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 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; 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 hospital) after rural emergency hospital . (c) Effective date The amendments made by this section shall apply beginning January 1, 2027.

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