S. 4460Senate119th Congress (2025-2027)Passed Senate

Rural Community Hospital Demonstration Program Reauthorization

Introduced April 30, 2026

AI-Generated Summary

Updated May 22, 2026 at 2:42 AM UTC

This bill reauthorizes the Rural Community Hospital Demonstration Program by lengthening its duration to a total of 20 years. It changes the statutory language to match the longer term and expands eligibility so that hospitals that weren’t original participants can receive the program’s benefits during a specific extension window. The changes affect rural community hospitals that take part in the demonstration program.

Key Provisions

  • Extends the Rural Community Hospital Demonstration Program from its original 15‑year term to a total of 20 years.
  • Updates the law’s language to reflect the new 20‑year extension period throughout the relevant sections.
  • Allows the program’s rules to apply to additional rural hospitals that join the demonstration after the original start, specifically covering a new extension period from Dec 30 2024 to Jan 1 2027.

Legislative Activity

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6 earlier actions
HouseFloor Latest Action

Held at the desk.

May 21, 2026 • 3:30 PM

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SenateIntro Referral

Introduced in Senate

April 30, 2026

SenateIntro Referral

Read twice and referred to the Committee on Finance.

April 30, 2026

SenateCommittee

Senate Committee on Finance discharged by Unanimous Consent.

May 20, 2026

SenateFloor

Passed Senate without amendment by Unanimous Consent. (consideration: CR S2428; text: CR S2428)

May 20, 2026

SenateFloor

Message on Senate action sent to the House.

May 21, 2026

HouseFloor

Received in the House.

May 21, 2026 • 3:18 PM

HouseFloor

Held at the desk.

May 21, 2026 • 3:30 PM

Floor Debate

1 member

What members said about S. 4460 on the floor

1 Republican
John Barrasso
Sen. John BarrassoR-WY · May 20, 2026

Mr. President, I ask unanimous consent that the Committee on Finance be discharged from further consideration of S. 4460 and the Senate proceed to its immediate consideration. I ask unanimous consent…

Bill Text

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Latest
Engrossed in SenateIssued May 20, 2026

119th CONGRESS

2d Session

S. 4460

AN ACT

To provide for an extension of the rural community hospital demonstration program.

1.

Short title

This Act may be cited as the Rural Community Hospital Demonstration Program Reauthorization.

2.

Five-year extension of the rural community hospital demonstration program

(a)

In general

Subsection (a)(5) of section 410A of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (Public Law 108–173; 42 U.S.C. 1395ww note), is amended by striking 15-year extension period and inserting 20-year extension period.

(b)

Conforming amendments for extension

(1)

Extension of demonstration period

Subsection (g) of such section 410A is amended—

(A)

in the subsection heading, by striking Fifteen-Year and inserting Twenty-Year;

(B)

in paragraph (1)—

(i)

by striking additional 15-year and inserting additional 20-year; and

(ii)

by striking 15-year extension period and inserting 20-year extension period;

(C)

in paragraph (2), by striking 15-year extension period and inserting 20-year extension period;

(D)

in paragraph (3), by striking 15-year extension period and inserting 20-year extension period;

(E)

in paragraph (4), by striking 15-year extension period each place it appears and inserting 20-year extension period;

(F)

in paragraph (5), by striking 15-year extension period each place it appears and inserting 20-year extension period; and

(G)

in subparagraph (A) of paragraph (6), by striking 15-year extension period and inserting 20-year extension period.

(2)

Rule for hospitals that are not original participants in the demonstration

Paragraph (5) of subsection (g) of such section 410A is amended—

(A)

in subparagraph (B), by striking Additional extension and inserting CAA, 2021 extension; and

(B)

by adding at the end the following new subparagraph:

(C)

Additional extension

During the fourth 5 years of the 20-year extension period, the Secretary shall apply the provisions of paragraph (4) to rural community hospitals that are not described in paragraph (4) but are participating in the demonstration program under this section at any time during the period beginning on December 30, 2024, and ending on January 1, 2027, in a similar manner as such provisions apply to rural community hospitals described in paragraph (4).

.

Passed the Senate May 20, 2026.

Secretary