PEAKS Act
- Bill Number
- H.R. 3778
- Origin Chamber
- House
- Congress
- 119th Congress, Session 1
- Policy Area
- Health
- Status
- Introduced
- Latest Action
- 2025-06-05: Referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
- Last Updated
- 2025-10-29T08:06:09Z
AI-Generated Summary
Purpose
The Preserving Emergency Access in Key Sites Act (PEAKS Act) aims to update Medicare reimbursement rules for ambulance services provided by critical access hospitals (CAHs). CAHs are small, rural hospitals that receive special Medicare payments to support healthcare in underserved areas. The bill adjusts distance-based criteria to better account for challenging terrains, ensuring fairer payments and maintaining hospital designations in remote locations.
Key Provisions
- Short Title (Section 1): The bill is officially named the "Preserving Emergency Access in Key Sites Act" or "PEAKS Act."
- Update to Ambulance Fee Schedule (Section 2): Amends the Social Security Act to revise the mileage threshold for higher Medicare reimbursements for ambulance services from CAHs. Specifically, it changes the standard 35-mile drive limit to a 15-mile drive limit in areas with mountainous terrain or only secondary roads available. This allows CAHs in such areas to qualify for increased payments for longer trips.
- Treatment of Existing CAHs (Section 3): Adds rules for hospitals already designated as CAHs that previously met a 15-mile distance requirement due to terrain or roads. Starting January 1, 2026:
- These hospitals are automatically considered to meet the updated 15-mile requirement.
- Eligibility applies if the hospital can show it qualified under the old rule at its last certification and if a new hospital or facility opens 10–15 miles away.
- The Secretary of Health and Human Services must issue regulations within one year to implement this.
Significant Changes to Existing Law
- Ambulance Reimbursement Adjustment: Previously, CAH ambulance services received higher Medicare fees only for trips beyond 35 miles. The bill lowers this to 15 miles in mountainous or secondary-road areas, making it easier for rural CAHs to access elevated payments without needing to travel as far.
- Grandfathering for CAH Designations: Introduces a new provision to protect existing CAH status for hospitals affected by nearby new facilities (within 10–15 miles). This prevents loss of special CAH benefits, which include cost-based Medicare reimbursements rather than standard rates, even if proximity rules might otherwise disqualify them.
Potential Impacts
- On Government Agencies: The Department of Health and Human Services (HHS) and Centers for Medicare & Medicaid Services (CMS) will need to update regulations, fee schedules, and certification processes, potentially increasing administrative workload but improving equity in rural payments.
- On Citizens: Rural Medicare beneficiaries in remote or rugged areas may gain better access to emergency ambulance services, as CAHs could receive fairer reimbursements to sustain operations. This could reduce service closures and improve response times in underserved communities.
- On International Relations: No direct impacts, as the bill focuses on domestic U.S. healthcare policy under Medicare.
Main Stakeholders Affected
- Critical Access Hospitals (CAHs): Primarily rural facilities that benefit from adjusted reimbursements and protected designations, helping them stay financially viable.
- Rural Communities and Residents: Especially in mountainous or low-road-access areas, who rely on these hospitals for emergency care.
- Medicare Beneficiaries: Older adults and disabled individuals using ambulance services, who may see more reliable coverage.
- Healthcare Providers: Ambulance operators and hospital staff affiliated with CAHs, facing potential operational stability.
- Federal Government (HHS/CMS): Responsible for implementation, oversight, and budgeting for Medicare expenditures.
Notable Legal, Constitutional, or Political Implications
- Legal Implications: The changes clarify and expand eligibility under the Social Security Act, potentially reducing disputes over CAH certifications and reimbursements. The one-year regulatory deadline ensures timely enforcement without immediate legal challenges.
- Constitutional Implications: None significant; the bill aligns with Congress's authority to regulate interstate commerce and social welfare programs like Medicare, without infringing on states' rights or individual liberties.
- Political Implications: Supports rural healthcare priorities, which could appeal to lawmakers from underserved districts. By addressing terrain-specific challenges, it promotes equity in federal funding without broad spending increases, though it may spark debates on Medicare cost controls.
This summary was generated by AI and may contain inaccuracies. Refer to the official source document for the authoritative text.
Sponsor
Rep. Miller, Carol D. [R-WV-1]
Cosponsors (3)
Rep. Lofgren, Zoe [D-CA-18], Rep. Moore, Riley M. [R-WV-2], Rep. Harder, Josh [D-CA-9]
Recent Actions
- 2025-06-05: Referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
- 2025-06-05: Referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
- 2025-06-05: Introduced in House
- 2025-06-05: Introduced in House
Bill Versions
- Preserving Emergency Access in Key Sites Act — issued 2025-06-05 — PDF (3 pages)