PEAKS Act
Sponsored By: Representative Miller (WV)
Introduced
Summary
Eases distance rules to help rural hospitals keep Critical Access Hospital status and maintain ambulance fee protections. The bill would add a 15-mile drive option for mountainous terrain or areas with only secondary roads and create a pathway for certain hospitals to be treated as meeting that distance starting January 1, 2026.
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- Critical Access Hospitals: Would add a 15-mile alternative to the ambulance fee schedule safe harbor for mountainous terrain or areas with only secondary roads. This changes the distance test used in ambulance fee schedule rules for affected hospitals.
- Hospitals with new facilities: Would create a pathway so hospitals that were CAHs on enactment and can demonstrate they met the 15-mile test at their last certification would be deemed to meet the 15-mile requirement beginning January 1, 2026. The new facility must be located at least 10 but no more than 15 miles from the hospital.
- Rules and timing: Would require the Secretary to issue regulations to implement this pathway within one year of enactment.
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Bill Overview
Analyzed Economic Effects
2 provisions identified: 2 benefits, 0 costs, 0 mixed.
Medicare ambulance rule eased in rural areas
If enacted, Medicare would let some ambulance trips count at 15 miles. This would apply when a critical access hospital (a small rural hospital) sends the ambulance in mountains or where only secondary roads exist. It would be an alternative to the usual 35-mile rule. This could help more trips qualify for Medicare payment. It would start upon enactment.
Protect rural hospital status near new facilities
Starting January 1, 2026, some small rural hospitals could be treated as meeting the 15-mile rural rule. To qualify, the hospital must already be a critical access hospital on the enactment date and show it met the 15-mile mountain/secondary-road standard at its last certification. After enactment, a new hospital or other facility must open 10 to 15 miles away. The Secretary would set regulations within 1 year of enactment.
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Sponsors & CoSponsors
Sponsor
Miller (WV)
WV • R
Cosponsors
Rep. Lofgren, Zoe [D-CA-18]
CA • D
Sponsored 6/5/2025
Moore (WV)
WV • R
Sponsored 6/6/2025
Rep. Harder, Josh [D-CA-9]
CA • D
Sponsored 10/28/2025
Roll Call Votes
No roll call votes available for this bill.
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