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<dc:title>119 HR 8986 IH: Ensuring Rural Health Care Access for Military and Tribal Families Act</dc:title>
<dc:publisher>U.S. House of Representatives</dc:publisher>
<dc:date>2026-05-21</dc:date>
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<dc:language>EN</dc:language>
<dc:rights>Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain.</dc:rights>
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<distribution-code display="yes">I</distribution-code><congress display="yes">119th CONGRESS</congress><session display="yes">2d Session</session><legis-num display="yes">H. R. 8986</legis-num><current-chamber>IN THE HOUSE OF REPRESENTATIVES</current-chamber><action display="yes"><action-date date="20260521">May 21, 2026</action-date><action-desc><sponsor name-id="N000189">Mr. Newhouse</sponsor> (for himself and <cosponsor name-id="L000560">Mr. Larsen of Washington</cosponsor>) introduced the following bill; which was referred to the <committee-name committee-id="HWM00">Committee on Ways and Means</committee-name></action-desc></action><legis-type>A BILL</legis-type><official-title display="yes">To amend title XVIII of the Social Security Act to allow for the designation of certain facilities as critical access hospitals under the Medicare program.</official-title></form><legis-body id="H70D47F7F71B7411CA9416F34A9AEC40A" style="OLC"> 
<section id="H21F5C69D2AED48F992F9BB29278BF0E8" section-type="section-one" commented="no"><enum>1.</enum><header>Short title</header><text display-inline="no-display-inline">This Act may be cited as the <quote><short-title>Ensuring Rural Health Care Access for Military and Tribal Families Act</short-title></quote>.</text> </section> <section id="H11DFDB2B40AD4B28A9C2779C2549FA6C"><enum>2.</enum><header>Providing essential health care access for members of the Armed Forces, dependents, and veterans in rural areas</header><text display-inline="no-display-inline">Section 1820(c)(2) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395i-4">42 U.S.C. 1395i–4(c)(2)</external-xref>) is amended—</text> 
<paragraph id="HC0E6F7275EC54339A576F608AC96DA6F"><enum>(1)</enum><text>in subparagraph (B)(i), by inserting <quote>subject to subparagraph (F),</quote> before <quote>is a hospital</quote>;</text></paragraph> <paragraph id="H37631C6DA6054461BE08CDBCA58E1444"><enum>(2)</enum><text>in subparagraph (E)(ii), by striking <quote>The total</quote> and inserting <quote>Subject to subparagraph (F), the total</quote>; and</text></paragraph> 
<paragraph id="H98418D44E5864FA487EE1DC03622482F"><enum>(3)</enum><text>by adding at the end the following new subparagraph:</text> <quoted-block id="H969AB47203004DB98F684418E765E54C" style="OLC"> <subparagraph id="H5CEDBF9B0D01418BBAFB15660D0A7BC2"><enum>(F)</enum><header>Essential health care access for members of the Armed Forces, dependents, and veterans in rural areas</header> <clause id="H6D2E1786359D49B0BD975585BE9D390F"><enum>(i)</enum><header>In general</header><text display-inline="yes-display-inline">Beginning October 1, 2026, a State may designate a facility as a critical access hospital without regard to the criteria under subparagraph (B)(i) if the facility meets 3 or more of the following criteria:</text> 
<subclause id="H1E2875874EFB45CBA1AD30BA545B1E95"><enum>(I)</enum><text display-inline="yes-display-inline">The hospital—</text> <item id="HD39E7677DD7140279EF42AD552C31B30"><enum>(aa)</enum><text>delivers health care services to individuals covered under the TRICARE program (as defined in section 1072 of title 10, United States Code) and veterans enrolled in the patient enrollment system under section 1705 of title 38, United States Code, living in rural areas; and</text> </item> 
<item id="HFDD898F391A14256AE87E3EABCF804B9"><enum>(bb)</enum><text display-inline="yes-display-inline">is located in a county (or equivalent unit of local government) in a rural area (as defined in section 1886(d)(2)(D)) or is treated as being located in a rural area pursuant to section 1886(d)(8)(E), or is located in an area that otherwise meets the definition of rural established by the Federal Office of Rural Health Policy.</text></item></subclause> <subclause id="H3644D1E8A63D4E0EA346861C6E61A665"><enum>(II)</enum><text>The hospital is not a sole community hospital (as defined in section 1886(d)(5)(D)(iii)).</text></subclause> 
<subclause id="H520414BB1FA14FBEB3231C9194F87570"><enum>(III)</enum><text display-inline="yes-display-inline">At the time of designation, 8 percent or more of the annual gross revenue of the hospital and its provider-based departments, including affiliated outpatient department and provider-based clinics, is derived from services provided to individuals covered under the TRICARE program.</text></subclause> <subclause id="HB8CED6DA7BA446CFB2DD62E4045EEE88"><enum>(IV)</enum><text display-inline="yes-display-inline">At the time of designation, 15 percent or more of the annual gross revenue from labor and delivery services of the hospital is derived from services provided to individuals covered under the TRICARE program.</text></subclause> 
<subclause id="H04D5809A930F49E68647B539ACBB6307"><enum>(V)</enum><text>The hospital is located on a reservation (as defined in section 4 of the Indian Health Care Improvement Act).</text></subclause></clause> <clause id="H08E0C7341D9F4F2089B7AE086E82EBF9"><enum>(ii)</enum><header>Psychiatric and rehabilitation distinct part units</header><text display-inline="yes-display-inline">A facility described in clause (i) may establish a distinct part unit under subparagraph (E) without regard to the limitation on number of beds under clause (ii) of such subparagraph. The Secretary may not take a distinct part unit so established by such facility into account when determining whether such facility is primarily engaged in providing the services described in section 1861(e)(1).</text></clause></subparagraph><after-quoted-block>.</after-quoted-block></quoted-block></paragraph></section> 
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