Defend Rural Health Act of 2026

Limits and protections for rural hospitals

This bill would tighten how Medicare decides whether certain hospitals count as rural. For fiscal years starting October 1, 2026, the Medicare review board would be barred from approving or making reclassifications effective for any part of a year when a hospital is treated as rural under paragraph (8)(E). Hospitals seeking reclassification would generally have to be located in an urban area and meet one of the listed criteria. On or after October 1, 2029, a hospital would not be treated as rural under the rule unless it demonstrates to the Secretary, in the required form, that it meets one of those criteria. A hospital that files an application before October 1, 2026 may rely on the prior criteria, and the bill would require any "designation by law" used as a criterion to have been in place on January 1, 2026.