S. 4460 · Where this bill is now
In the House
Passed the Senate May 20, 2026. Received May 21, 2026; no House vote yet
What this bill does
In plain words · AI-written from the official summaryExtends rural hospital payment testing program
The Rural Community Hospital Demonstration Program tests a different way to pay small rural hospitals through Medicare. Instead of the usual payment method, these hospitals get reimbursed based on their actual costs. This bill keeps the program running for five more years and lets hospitals that join by early 2027 stay in it through the extension.
How it affects you
If you live in a rural area and rely on a small hospital, this program could affect your local healthcare. The hospitals in this program are testing whether cost-based payments help them stay financially stable. However, this bill is mainly about whether the experiment should continue—it doesn't directly change what you pay or how you receive care.
Read the official summary (Introduced in Senate, Apr 30, 2026)
Rural Community Hospital Demonstration Program Reauthorization
This bill extends the Rural Community Hospital Demonstration Program for an additional five years. The program tests the feasibility of cost-based reimbursement under Medicare for small rural hospitals that are too large to qualify for special payment as critical access hospitals.
The bill specifies that hospitals that participate in the program between December 30, 2024, and January 1, 2027, may continue to participate during the five-year extension period.
Written by AI (Claude) using only the official summary by the Congressional Research Service, the Library of Congress’s nonpartisan research staff. It can miss nuance, so check the official summary and the bill text for details.
2nd SessionS. 4460
AN ACT
Rural Community Hospital Demonstration Program Reauthorization
Sponsor: Sen. Chuck Grassley (R-IA) · Introduced Apr 30, 2026 · Health · 2 versions of the text
Sources: Congress.gov actions and votes · bill text from GovInfo · latest official action May 21, 2026: “Held at the desk.”
Sections
The wording of this bill hasn’t changed across its 2 official versions.