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H.R. 489: Protecting Rural Access to Care Act

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The summary below was written by the Congressional Research Service, which is a nonpartisan division of the Library of Congress, and was published on Jan 25, 2021.

Protecting Rural Access to Care Act

This bill limits the scope of guidance issued by the Centers for Medicare & Medicaid Services (CMS) regarding the secondary road criteria for Medicare critical access hospitals (CAHs).

Currently, in order to qualify as a CAH under Medicare, a hospital must either (1) be located more than 35 miles (15 miles in mountainous regions or areas with only secondary roads) from another hospital, or (2) have been certified prior to January 1, 2006, by the state as a necessary provider of services in the area.

The CMS issued guidance on July 31, 2015, that provided more detail as to the differences between primary and secondary roads for purposes of CAH certification. The bill specifies that this guidance does not apply to CAHs that were certified prior to July 31, 2015, and that these CAHs are instead subject to the standards that were in place before the guidance was issued. Ongoing CAH certifications are also subject to pre-guidance standards until the CMS issues new guidance after a specified public comment period.