Rural Hospital Closure Relief Act of 2025

This bill allows states to waive the 35-mile rule for certain rural hospitals seeking Critical Access Hospital (CAH) designation under Medicare. It targets hospitals that are sole community hospitals, Medicare-dependent small rural hospitals, low-volume hospitals, or subsection (d) hospitals located in high-poverty or health professional shortage areas, with two consecutive years of negative margins. To qualify, hospitals must commit to adding high-demand services like obstetrics or behavioral health and submit annual reports on these services. The bill caps total CAH designations at 120 nationwide (5 per state) and requires transition to new payment models after 9 years. It also mandates studies by GAO and MedPAC to evaluate impacts on access and costs.