Defend Rural Health Act of 2026

Limiting Geographic Reclassification: The bill amends Section 1886(d)(8)(E) of the Social Security Act to limit how hospitals in urban areas meet specific criteria to be treated as rural. This could provide more predictable geographic classifications for the Medicare program (Section 2(a)).

Preventing Dual Reclassifications: By amending Section 1886(d)(10)(D), the bill provides guidelines that prevent the Medicare Geographic Classification Review Board from approving certain applications if a hospital is already being treated as located in a rural area under specific paragraphs (Section 2(b)).

Restrictions on Hospital Reclassification: Under Section 2(a)(3), no subsection (d) hospital shall be treated as located in a rural area on or after October 1, 2029, unless the hospital demonstrates to the Secretary that it meets specific criteria. This creates a deadline and specific requirements for hospitals seeking rural status.

Limitations on Board Decisions: According to Section 2(b), for fiscal years beginning on or after October 1, 2026, no change in geographic classification resulting from a Board decision will be effective if the hospital is already being treated as located in a rural area under paragraph (8)(E). This limits the effectiveness of decisions made by the Medicare Geographic Classification Review Board.