Rural Community Hospital Demonstration Program Reauthorization, the official text

108 S4460 ES: Rural Community Hospital Demonstration Program Reauthorization
U.S. Senate
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119th CONGRESS 2d Session S. 4460 IN THE SENATE OF THE UNITED STATES AN ACT To 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).
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Passed the Senate May 20, 2026. Secretary