Critical access hospital improvements

(a) Elimination of isolation test for cost-Based ambulance reimbursement (1) In general Section 1834(l)(8) of the Social Security Act (42 U.S.C. 1395m(l)(8)) is amended— (A) in subparagraph (B)— (i) by striking owned and; and (ii) by inserting (including when such services are provided by the entity under an arrangement with the hospital) after hospital; and (B) by striking the comma at the end of subparagraph (B) and all that follows and inserting a period. (2) Effective date The amendments made by this subsection shall apply to services furnished on or after January 1, 2027. (b) Provision of a more flexible alternative to the CAH designation 25 inpatient bed limit requirement (1) In general Section 1820(c)(2) of the Social Security Act (42 U.S.C. 1395i–4(c)(2)) is amended— (A) in subparagraph (B)(iii), by striking provides not more than and inserting subject to subparagraph (F), provides not more than; and (B) by adding at the end the following new subparagraph: (F) Alternative to 25 inpatient bed limit requirement (i) In general A State may elect to treat a facility, with respect to the designation of the facility for a cost reporting period, as satisfying the requirement of subparagraph (B)(iii) relating to a maximum number of acute care inpatient beds if the facility elects, in accordance with a method specified by the Secretary and before the beginning of the cost reporting period, to meet the requirement under clause (ii). (ii) Alternate requirement The requirement under this clause, with respect to a facility and a cost reporting period, is that the total number of inpatient bed days described in subparagraph (B)(iii) during such period will not exceed 7,300. For purposes of this subparagraph, an individual who is an inpatient in a bed in the facility for a single day shall be counted as one inpatient bed day. (iii) Withdrawal of election The option described in clause (i) shall not apply to a facility for a cost reporting period if the facility (for any two consecutive cost reporting periods during the previous 5 cost-reporting periods) was treated under such option and had a total number of inpatient bed days for each of such two cost reporting periods that exceeded the number specified in such clause.. (2) Effective date The amendments made by paragraph (1) shall apply to cost reporting periods beginning on or after the date of the enactment of this Act.