# 119-hr-5821: Rural Hospital Fairness Act

119-hr-5821, Rural Hospital Fairness Act, is a 119th Congress bill sponsored by Rep. LaMalfa, Doug [R-CA-1] (R-CA); status introduced; PRIA reads it as touching household money (as of 2026-04-21).

- Canonical: https://policyrisk.com/legislation/119-hr-5821
- As of: 2026-04-21
- Plain-text twin of the page above; the HTML and this file carry the same facts.

## Facts
- Bill: 119-hr-5821
- Congress: 119
- Title: Rural Hospital Fairness Act
- Status: introduced
- Introduced: 2025-10-24
- Sponsor: Rep. LaMalfa, Doug [R-CA-1] (R-CA)
- Cosponsors: 0
- Policy area: Health
- Touches household money: yes
- Last recorded action: 2026-04-21

## Summary

**Preserve critical access hospital (CAH) status** for certain long-standing rural hospitals. This bill would allow facilities that were CAHs before January 1, 2002 and were Secretary-certified as of December 31, 2024 to be treated as CAHs under Medicare even if they no longer meet the location-based eligibility rule, so long as they remain otherwise eligible and meet any additional Secretary criteria and state designation requirements. - Rural hospitals. Facilities that were CAHs before January 1, 2002 and certified by the Secretary as of December 31, 2024 could be deemed to retain CAH treatment for as long as they meet ongoing eligibility and Secretary standards. - Rural communities. The text specifically covers facilities in counties with no other hospital, CAH, or rural emergency hospital, aiming to keep a local CAH in those areas when the listed conditions are met. - State and federal roles. States still must designate facilities as CAHs and the Secretary retains authority to set criteria under the applicable subsection.

## Provisions PRIA read

- Keep Medicare help for rural hospitals: benefit, low. If enacted, some small rural hospitals would keep their Medicare critical access status. This could happen even if they no longer meet the distance rule and were not named a "necessary provider" by the state. It would apply only to facilities that were CAHs before January 1, 2002, were still certif…

## Related bills

- 119-hr-2725: Affordable Housing Credit Improvement Act of 2025
- 119-hr-471: Fix Our Forests Act
- 119-hr-1229: United States-Israel Defense Partnership Act of 2025
- 119-hr-2619: No Paydays for Hostage-Takers Act
- 119-hr-3898: PERMIT Act
- 119-hr-2709: Save Our Sequoias Act

## Sources
- [119-hr-5821 on Congress.gov](https://www.congress.gov/bill/119th-congress/house-bill/5821)

## Related
- [119-hr-2725: Affordable Housing Credit Improvement Act of 2025](https://policyrisk.com/legislation/119-hr-2725)
- [119-hr-471: Fix Our Forests Act](https://policyrisk.com/legislation/119-hr-471)
- [119-hr-1229: United States-Israel Defense Partnership Act of 2025](https://policyrisk.com/legislation/119-hr-1229)
- [119-hr-2619: No Paydays for Hostage-Takers Act](https://policyrisk.com/legislation/119-hr-2619)
- [119-hr-3898: PERMIT Act](https://policyrisk.com/legislation/119-hr-3898)
- [119-hr-2709: Save Our Sequoias Act](https://policyrisk.com/legislation/119-hr-2709)
- [All bills in Congress](https://policyrisk.com/legislation)

Source: PRIA, https://policyrisk.com/legislation/119-hr-5821 (as of 2026-04-21).