HR538119th CongressWALLET

Critical Access Hospital Relief Act of 2025

Sponsored By: Representative Smith (NE)

Introduced

Summary

Eliminates the 96-hour physician certification for inpatient Critical Access Hospital (CAH) services under Medicare. It limits the change to inpatient CAH services and takes effect for items and services furnished on or after January 1, 2026.

Show full summary
  • Critical Access Hospitals: Would no longer be subject to the 96-hour physician certification requirement for inpatient services under section 1814(a) of the Social Security Act.
  • Physicians and clinicians: Would not need to provide the 96-hour inpatient certification for patients in CAHs for services furnished on or after Jan 1, 2026.
  • Medicare beneficiaries: Inpatient CAH services furnished on or after Jan 1, 2026 would no longer be tied to that specific physician certification rule.
  • Federal program rules: The bill adds no new programs, funding, or benefit structures and leaves care provided before 2026 governed by existing law.

Your PRIA Score

Score Hidden

Personalized for You

How does this bill affect your finances?

Sign up for a PRIA Policy Scan to see your personalized alignment score for this bill and every other piece of legislation we track. We analyze your financial profile against policy provisions to show you exactly what matters to your wallet.

Free to start

Bill Overview

Analyzed Economic Effects

1 provisions identified: 1 benefits, 0 costs, 0 mixed.

Medicare: 96-hour rule would end at Critical Access Hospitals

This bill would remove Medicare’s 96-hour physician certification for inpatient stays at Critical Access Hospitals. It would apply to care given on or after January 1, 2026. If enacted, you and your doctor would face fewer paperwork steps for these rural hospital stays. It would not change rules for other hospitals or other Medicare services.

Sponsors & CoSponsors

Sponsor

Smith (NE)

NE • R

Cosponsors

  • Sewell

    AL • D

    Sponsored 1/16/2025

  • Bergman

    MI • R

    Sponsored 10/24/2025

Roll Call Votes

No roll call votes available for this bill.

View on Congress.gov
Back to Legislation

Take It Personal

Get Your Personalized Policy View

Start a Free Government Policy Watch to see how policy affects your household, then upgrade to PRIA Full Coverage for year-round monitoring.

Already have an account? Sign in