H.R. 7409

[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 7409 Introduced in House (IH)]

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119th CONGRESS
2d Session
H. R. 7409

To amend title XVIII of the Social Security Act to limit the geographic 
reclassification of certain hospitals under the Medicare program.

_______________________________________________________________________

IN THE HOUSE OF REPRESENTATIVES

February 5, 2026

Mr. Taylor (for himself and Mrs. Miller of West Virginia) introduced 
the following bill; which was referred to the Committee on Ways and 
Means

_______________________________________________________________________

A BILL

To amend title XVIII of the Social Security Act to limit the geographic 
reclassification of certain hospitals under the Medicare program.

Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

This Act may be cited as the ``Defend Rural Health Act of 2026''.

SEC. 2. LIMITING GEOGRAPHIC RECLASSIFICATION OF HOSPITALS UNDER 
MEDICARE.

(a) In General.--Section 1886(d)(8)(E) of the Social Security Act 
(42 U.S.C. 1395ww(d)(8)(E)) is amended--
(1) in clause (i), by striking ``described in clause (ii)'' 
and inserting ``that is located in an urban area (as defined in 
paragraph (2)(D)) and meets any of the criteria described in 
subclause (I), (II), or (IV) of clause (ii) (or, with respect 
to a hospital submitting such an application before October 1, 
2026, meets any of the criteria described in such clause)'';
(2) in clause (ii)--
(A) in the matter preceding subclause (I), by 
striking ``a subsection (d) hospital'' and all that 
follows through ``criteria:'' and inserting ``the 
criteria described in this clause are the following:''; 
and
(B) in subclause (II)--
(i) by inserting ``that is'' before 
``designated by any law''; and
(ii) by inserting ``, and that was so 
designated as of January 1, 2026'' before the 
period at the end; and
(3) by adding at the end the following new clause:
``(iii) No subsection (d) hospital shall be treated as being 
located in a rural area of a State under this subparagraph on or after 
October 1, 2029, regardless of any application described in clause (i) 
submitted prior to October 1, 2026, unless such hospital demonstrates 
to the Secretary (in a form and manner specified by the Secretary) that 
such hospital meets any of the criteria described in subclause (I), 
(II), or (IV) of clause (ii).''.
(b) Prohibiting Dual Reclassifications Through the Medicare 
Geographic Classification Review Board.--Section 1886(d)(10)(D) of the 
Social Security Act (42 U.S.C. 1395ww(d)(10)(D)) is amended--
(1) in clause (v), by striking ``Any decision'' and 
inserting ``Subject to clause (viii), any decision''; and
(2) by adding at the end the following new clauses:
``(vii) Such guidelines shall provide that the Board may not 
approve an application described in subparagraph (C)(i) submitted by a 
subsection (d) hospital requesting a change in geographic 
classification for a fiscal year beginning on or after October 1, 2026, 
if such hospital is treated as being located in a rural area under 
paragraph (8)(E) for such fiscal year.
``(viii) With respect to a fiscal year beginning on or after 
October 1, 2026, no change in the geographic classification of a 
subsection (d) hospital that would otherwise be in effect for such 
fiscal year pursuant to a decision of the Board shall be effective for 
any portion of such fiscal year during which such hospital is treated 
as being located in a rural area under paragraph (8)(E).''.
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