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Defend Rural Health Act of 2026
To amend title XVIII of the Social Security Act to limit the geographic reclassification of certain hospitals under the Medicare program.
Summary
The Defend Rural Health Act of 2026 would limit the ability of hospitals to change their geographic classification from urban to rural under the Medicare program. The bill restricts geographic reclassification applications to hospitals located in urban areas that meet specific criteria, and requires hospitals applying after October 1, 2026, to continue meeting those criteria to be treated as rural after October 1, 2029. The bill also prohibits hospitals from being reclassified through the Medicare Geographic Classification Review Board for fiscal years beginning October 1, 2026 or later if they are already classified as rural under the bill's new rules. These changes are intended to prevent hospitals from obtaining dual geographic classifications that could affect their Medicare payment rates. The bill's restrictions on reclassification would take effect at different times, with full implementation by October 1, 2029.
AI-generated plain-language summary of the bill text — neutral, and may be imperfect. See the full text below for the exact wording.
Sponsor (1)
14 cosponsors
- Rep. Amodei, Mark E. [R-NV-2] (R-NV)
- Rep. Arrington, Jodey C. [R-TX-19] (R-TX)
- Rep. Babin, Brian [R-TX-36] (R-TX)
- Rep. Bacon, Don [R-NE-2] (R-NE)
- Rep. Bergman, Jack [R-MI-1] (R-MI)
- Rep. Cloud, Michael [R-TX-27] (R-TX)
- Rep. Fine, Randy [R-FL-6] (R-FL)
- Rep. Flood, Mike [R-NE-1] (R-NE)
- Rep. Mann, Tracey [R-KS-1] (R-KS)
- Rep. Miller, Carol D. [R-WV-1] (R-WV)
- Rep. Onder, Robert F. [R-MO-3] (R-MO)
- Rep. Scott, Austin [R-GA-8] (R-GA)
- Rep. Smith, Adrian [R-NE-3] (R-NE)
- Rep. Van Duyne, Beth [R-TX-24] (R-TX)
Actions (2)
- Feb 5, 2026 Referred to the House Committee on Ways and Means. · house
- Feb 5, 2026 Introduced in House
Similar bills (6)
Bills with similar text or summary — includes reintroductions across Congresses. Ranked by semantic similarity of the bill text (computed locally); a neutral discovery aid, not a claim the bills are duplicates.
Full text
IN THE HOUSE OF REPRESENTATIVES
February 5, 2026
Mr. Taylor (for himself and Mrs. Miller of West Virginia) introduced the following bill; which was referred to the Committee on Ways and Means
A BILL
To amend title XVIII of the Social Security Act to limit the geographic reclassification of certain hospitals under the Medicare program.
Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the “Defend Rural Health Act of 2026”.
SEC. 2. LIMITING GEOGRAPHIC RECLASSIFICATION OF HOSPITALS UNDER MEDICARE.
(a) In General.—Section 1886(d)(8)(E) of the Social Security Act (42 U.S.C. 1395ww(d)(8)(E)) is amended—
(1) in clause (i), by striking “described in clause (ii)” and inserting “that is located in an urban area (as defined in paragraph (2)(D)) and meets any of the criteria described in subclause (I), (II), or (IV) of clause (ii) (or, with respect to a hospital submitting such an application before October 1, 2026, meets any of the criteria described in such clause)”;
(2) in clause (ii)—
(A) in the matter preceding subclause (I), by striking “a subsection (d) hospital” and all that follows through “criteria:” and inserting “the criteria described in this clause are the following:”; and
(B) in subclause (II)—
(i) by inserting “that is” before “designated by any law”; and
(ii) by inserting “, and that was so designated as of January 1, 2026” before the period at the end; and
(3) by adding at the end the following new clause:
“(iii) No subsection (d) hospital shall be treated as being located in a rural area of a State under this subparagraph on or after October 1, 2029, regardless of any application described in clause (i) submitted prior to October 1, 2026, unless such hospital demonstrates to the Secretary (in a form and manner specified by the Secretary) that such hospital meets any of the criteria described in subclause (I),
(II), or (IV) of clause (ii).”.
(b) Prohibiting Dual Reclassifications Through the Medicare Geographic Classification Review Board.—Section 1886(d)(10)(D) of the Social Security Act (42 U.S.C. 1395ww(d)(10)(D)) is amended—
(1) in clause (v), by striking “Any decision” and inserting “Subject to clause (viii), any decision”; and
(2) by adding at the end the following new clauses:
“(vii) Such guidelines shall provide that the Board may not approve an application described in subparagraph (C)(i) submitted by a subsection (d) hospital requesting a change in geographic classification for a fiscal year beginning on or after October 1, 2026, if such hospital is treated as being located in a rural area under paragraph (8)(E) for such fiscal year.
“(viii) With respect to a fiscal year beginning on or after October 1, 2026, no change in the geographic classification of a subsection (d) hospital that would otherwise be in effect for such fiscal year pursuant to a decision of the Board shall be effective for any portion of such fiscal year during which such hospital is treated as being located in a rural area under paragraph (8)(E).”. <all>
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