108 S4460 IS: Rural Community Hospital Demonstration Program Reauthorization U.S. Senate 2026-04-30 text/xml EN 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.

II119th CONGRESS2d SessionS. 4460IN THE SENATE OF THE UNITED STATESApril 30, 2026Mr. Grassley (for himself, Mr. Bennet, Mr. Crapo, Mr. Wyden, Mr. Sullivan, Mr. Luján, Mrs. Hyde-Smith, Mr. Welch, Mr. Moran, Mr. King, Ms. Murkowski, Mr. Merkley, Mr. Ricketts, Mr. Heinrich, Mr. Lankford, and Mr. Hickenlooper) introduced the following bill; which was read twice and referred to the Committee on FinanceA BILLTo provide for an extension of the rural community hospital demonstration program.

1.

Short title

This Act may be cited as the Rural Community Hospital Demonstration Program Reauthorization.

2.

Five-year extension of the rural community hospital demonstration program

(a)

In general

Subsection (a)(5) of section 410A of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (Public Law 108–173; 42 U.S.C. 1395ww note), is amended by striking 15-year extension period and inserting 20-year extension period.(b)

Conforming amendments for extension

(1)

Extension of demonstration period

Subsection (g) of such section 410A is amended—(A)in the subsection heading, by striking Fifteen-Year and inserting Twenty-Year;(B)in paragraph (1)—(i)by striking additional 15-year and inserting additional 20-year; and(ii)by striking 15-year extension period and inserting 20-year extension period;(C)in paragraph (2), by striking 15-year extension period and inserting 20-year extension period;(D)in paragraph (3), by striking 15-year extension period and inserting 20-year extension period;(E)in paragraph (4), by striking 15-year extension period each place it appears and inserting 20-year extension period;(F)in paragraph (5), by striking 15-year extension period each place it appears and inserting 20-year extension period; and(G)in subparagraph (A) of paragraph (6), by striking 15-year extension period and inserting 20-year extension period.(2)

Rule for hospitals that are not original participants in the demonstration

Paragraph (5) of subsection (g) of such section 410A is amended—(A)in subparagraph (B), by striking Additional extension and inserting CAA, 2021 extension; and(B)by adding at the end the following new subparagraph:(C)

Additional extension

During the fourth 5 years of the 20-year extension period, the Secretary shall apply the provisions of paragraph (4) to rural community hospitals that are not described in paragraph (4) but are participating in the demonstration program under this section at any time during the period beginning on December 30, 2024, and ending on January 1, 2027, in a similar manner as such provisions apply to rural community hospitals described in paragraph (4)..