PEAKS Act
- Bill Number
- S. 1960
- Origin Chamber
- Senate
- Congress
- 119th Congress, Session 1
- Policy Area
- Health
- Status
- Introduced
- Latest Action
- 2025-06-05: Read twice and referred to the Committee on Finance.
- Last Updated
- 2025-07-24T18:56:47Z
AI-Generated Summary
Purpose of the Legislation
The Preserving Emergency Access in Key Sites Act (PEAKS Act), S. 1960, aims to protect and support critical access hospitals (CAHs)—small, rural hospitals that receive special Medicare payments to ensure healthcare access in underserved areas. It addresses challenges posed by new nearby facilities and terrain-related barriers by maintaining CAH designations and adjusting rules for ambulance services.
Key Provisions
- Continued CAH Designation for Certain Hospitals (Section 2):
- Adds a new paragraph to Section 1820(h) of the Social Security Act.
- Hospitals already designated as CAHs as of the bill's enactment date will be considered to meet the 15-mile distance requirement (for mountainous terrain or areas with only secondary roads) even after January 1, 2026.
- Eligibility requires: (1) current CAH status; (2) proof that the hospital met the 15-mile criterion at its last certification (verified by the Secretary of Health and Human Services); and (3) a new hospital or similar facility built within 10-15 miles after enactment.
- The Secretary must issue regulations to implement this within one year of enactment.
- Adjusted Distance for Ambulance Services (Section 3):
- Amends Section 1834(l)(8) of the Social Security Act.
- For ambulance services provided by CAHs on or after January 1, 2026, in mountainous terrain or areas with only secondary roads, the required drive distance is reduced from 35 miles to 15 miles. This applies to Medicare coverage rules.
Significant Changes to Existing Law
- CAH Designation Rules: Current law requires CAHs to be at least 35 miles from another hospital (or 15 miles in mountainous/secondary road areas) to qualify for special Medicare status. This bill "grandfathers in" (automatically qualifies) existing CAHs that previously met the 15-mile rule, preventing loss of status due to new facilities built 10-15 miles away starting in 2026.
- Ambulance Service Distance: Existing law mandates a 35-mile drive for CAH ambulance services to qualify for Medicare payment in remote areas. The bill shortens this to 15 miles for specified terrains starting in 2026, making it easier for CAHs to bill Medicare for shorter trips in challenging areas.
Potential Impacts
- On Government Agencies: The Department of Health and Human Services (HHS), via the Centers for Medicare & Medicaid Services (CMS), will need to verify hospital certifications, issue new regulations, and update Medicare payment systems. This could increase administrative workload but ensure consistent rural healthcare funding.
- On Citizens: Medicare beneficiaries in rural, mountainous, or secondary-road areas will likely maintain better access to emergency and ambulance services without hospitals losing CAH status. This could reduce travel times for care and prevent hospital closures, benefiting vulnerable populations in remote locations.
- On International Relations: No direct impacts, as the bill focuses on domestic U.S. healthcare policy.
Main Stakeholders Affected
- Rural Hospitals and CAHs: Primary beneficiaries, as they retain higher Medicare reimbursements (cost-based payments instead of standard rates) and can continue providing essential services.
- Medicare Patients and Residents in Remote Areas: Gain sustained access to local healthcare, particularly emergency and ambulance transport, reducing risks from longer distances.
- Ambulance Providers: CAH-affiliated services can qualify for Medicare payments over shorter distances in tough terrains, potentially expanding operations.
- HHS and CMS: Responsible for implementation, including certification reviews and rulemaking, which may require additional resources.
- New or Nearby Hospitals: Could face indirect competition from preserved CAH statuses but are not directly restricted.
Notable Legal, Constitutional, or Political Implications
- Legal Implications: Strengthens Medicare's rural healthcare framework under Title XVIII of the Social Security Act by clarifying distance exceptions, potentially reducing future disputes over CAH re-designations. The one-year regulatory deadline ensures timely enforcement without broad rulemaking authority.
- 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 infrastructure, which could appeal to bipartisan interests in underserved regions (e.g., sponsors include senators from states like West Virginia and California with mountainous areas). It addresses potential gaps in existing law without major fiscal expansions, focusing on equity in federal payments.
This summary was generated by AI and may contain inaccuracies. Refer to the official source document for the authoritative text.
Sponsor
Sen. Capito, Shelley Moore [R-WV]
Cosponsors (4)
Sen. Padilla, Alex [D-CA], Sen. Justice, James C. [R-WV], Sen. Schiff, Adam B. [D-CA], Sen. Barrasso, John [R-WY]
Recent Actions
- 2025-06-05: Read twice and referred to the Committee on Finance.
- 2025-06-05: Introduced in Senate
Bill Versions
- Preserving Emergency Access in Key Sites Act — issued 2025-06-05 — PDF (3 pages)