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Representative LaMalfa warns rural critical‑access hospitals could close after CMS mileage recalculation
Summary
Rep. Doug LaMalfa told the Rules Committee that a recent Centers for Medicare & Medicaid Services (CMS) recalculation of the 35‑mile criterion for critical access hospital eligibility has threatened small rural hospitals' status and funding, citing his district's Glenn Medical Center as an example.
Representative Doug LaMalfa testified to the Rules Committee about a CMS administrative change that recalculated the 35‑mile distance used to determine eligibility for Critical Access Hospital (CAH) designation. LaMalfa said the recalculation — which he said used a new routing method (via Google Maps) and a path that would not be used in an emergency — pushed a hospital in his Northern California district, Glenn Medical Center, below the mileage threshold after decades of eligibility, jeopardizing the facility's critical‑access status and attendant funding streams.
LaMalfa told the committee that the change was discovered in April, that the hospital and community depend on the emergency‑service role the CAH designation supports, and that the loss of the designation could force layoffs and eventual closure. He described the county's sparse doctor-to‑resident ratio and the hospital's role as the nearest emergency facility for Interstate‑5 travelers.
The representative said he and the hospital had first sought administrative remedies but, with the hospital facing immediate financial and staffing pressure, asked for legislative relief or a temporary restoration of status while a permanent fix is worked out. LaMalfa estimated the number of U.S. hospitals affected could be under 490 but said the precise CMS estimate was pending.
Committee members urged collaboration with appropriations and authorizing committees to examine the administrative calculation, and some members — including the chairman of the Health Subcommittee on Energy and Commerce — offered to work with LaMalfa to find a technical solution that preserves emergency access in rural areas.
Ending
No committee action to change CMS policy was taken during the Rules hearing; members asked staff to pursue administrative or legislative pathways to buy time for affected hospitals and to examine CMS's calculation methodology.
