Sustaining Rural Healthcare Act
Sponsored By: Representative Alford, Mark [R-MO-4]
Introduced
Summary
Protect rural health care access. This bill creates temporary protections for Critical Access Hospitals and a new short‑term parity pathway so struggling rural hospitals can be paid like CAHs while they stabilize.
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- Families and rural patients: Keeps local hospital access in place by letting certain facilities keep their Critical Access Hospital designation for up to 3 years when losing it would reduce essential care in the service area.
- Rural hospitals and systems: Allows the Secretary to grant a temporary "Critical Access in Character" designation so hospitals receive Medicare inpatient and outpatient reimbursement at CAH rates while they fix financial or operational problems. Designations end once hospitals are stabilized and generally may not exceed 3 years unless renewed for good cause. The Secretary must issue guidance within 12 months and can require monitoring and documentation.
- Federal oversight and support: The bill requires a financial risk standard to target rural challenges not mismanagement. It lets the Secretary set limits and oversight and asks the Department of Agriculture to provide no‑cost technical assistance via its Community Facilities Program.
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Bill Overview
Analyzed Economic Effects
2 provisions identified: 1 benefits, 0 costs, 1 mixed.
Medicare parity for critical rural hospitals
If enacted, the bill would let HHS designate some rural hospitals as "Critical Access in Character." While designated, those hospitals would receive Medicare inpatient and outpatient payments like Critical Access Hospitals, subject to limits the Secretary sets. To qualify, hospitals would need to meet several tests, including rural location, being in shortage or underserved areas, serving many Medicare patients, and facing risk of closure. Designations would end when hospitals are stabilized and generally may not last more than three years unless renewed for good cause. The Secretary would issue guidance within 12 months, could require financial and operational documents, could add oversight, and would work with USDA to offer free technical help. The new label would not count as full Critical Access Hospital status under other laws.
Temporary protection for state rural hospitals
If enacted, the bill would let the Secretary temporarily treat a State-designated rural hospital as meeting a location rule for up to three years. This would apply only if the hospital met the location test when the State designated it and the Secretary finds that losing federal recognition would reduce local access to needed care. The temporary deeming would aim to avoid immediate disruptions to health services in the hospital's service area.
Sponsors & CoSponsors
Sponsor
Alford, Mark [R-MO-4]
MO • R
Cosponsors
Rep. Thompson, Glenn [R-PA-15]
PA • R
Sponsored 2/26/2026
Rep. Tokuda, Jill N. [D-HI-2]
HI • D
Sponsored 2/26/2026
Cuellar
TX • D
Sponsored 2/26/2026
Roll Call Votes
No roll call votes available for this bill.
View on Congress.gov