H.R. 5821 — Rural Hospital Fairness Act

This section establishes continued critical access hospital (CAH) status under Medicare for certain facilities that fail the program's location requirement. (As background, CAHs are small rural hospitals eligible for Medicare cost-based reimbursement—instead of standard prospective payments—to support health care access in underserved areas.) Specifically, a facility designated as a CAH before January 1, 2002, that was Secretary-certified as a CAH as of December 31, 2024, but later decertified, is deemed recertified as a CAH if located in a county (or equivalent) with no other hospital, CAH, or rural emergency hospital and if otherwise eligible under state designation criteria and Secretary requirements. (Thus, such facilities retain enhanced Medicare reimbursement.)