Office of U.S. Senator Deb Fischer
Today, U.S. Senator Deb Fischer (R-Neb.) reintroduced legislation to support rural hospitals. The Supporting Access to Rural Community Hospitals Act of 2025 grants rural hospitals flexibility when choosing reimbursement models so that they can have greater financial sustainability.
Currently, hospitals designated as Critical Access Hospitals (CAH) receive cost-based reimbursement for all services to address the needs of their rural communities. Hospitals in the Rural Community Hospital Demonstration (RCHD) program only receive cost-based reimbursement for some services, while maintaining a higher number of beds.
Senator Fischer’s legislation grants RCHD hospitals an optional, one-time election period to designate themselves as a CAH and meet the necessary eligibility requirements. The bill gives these essential hospitals the opportunity to choose between these two beneficial federal programs and enables them to continue serving their communities. U.S. Representatives Mike Flood (NE-01) and Adrian Smith (NE-03) introduced identical companion legislation in the House.
“Rural community hospitals ensure that every Nebraskan can access the health services they rely on, regardless of their zip code. Our legislation will help rural hospitals remain sustainable by giving them the option to choose the program that best suits their current needs. I look forward to working with my Nebraska delegation colleagues as we champion this legislation in both the Senate and the House,” said Senator Fischer. “Rural community hospitals are the backbone of healthcare across vast areas of Nebraska and the country. By giving these hospitals the ability to determine their future in the Rural Community Hospital Demonstration program, these facilities will be able to better meet their needs and the needs of the communities they serve, while also still delivering quality care to patients. Providing this option to hospitals currently in the RCHD program has the potential to unlock additional funding, empowering hospitals to expand and improve the services they provide. I am grateful to my fellow Nebraska colleagues, Congressman Smith and Senator Fischer, for their willingness to help lead this effort,” said Congressman Flood.
“Hospitals serving rural populations in Nebraska and across the country should operate under the Medicare reimbursement designations which best fit their needs and circumstances. This bill provides for commonsense regulatory flexibility ensuring such rural hospitals can best serve Nebraskans. I thank Rep. Flood and Sen. Fischer for working with me to advance this legislative solution,” said Congressman Smith.
The full text of the legislation can be viewed here.