Urge Congress to Expand Allowable Costs

Urge Congress to Expand Allowable Costs

The CARE Act is currently under consideration in the House and needs your support!
Has your Member of Congress signed on to co-sponsor the Critical Access and Rural Equity (CARE) Act? Click here to find out.
If your Member has not yet signed on to co-sponsor the CARE Act, contact your Member of Congress and tell them to support H.R. 3224.

The Critical Access and Rural Equity (CARE) Act (H.R. 3224) clarifies the definition of CAH allowable costs to include patient- and physician-centered expenses. H.R. 3224 identifies commonly cited auditor discrepancies and removes barriers to care by ensuring coverage of the most common diagnostic tests, health clinics, and physician recruitment and retention costs.

There is extreme variation between regions and auditors regarding what are considered allowable costs for CAHs. Creating a more uniform definition of allowable costs enables CAHs to continue their focus on care delivery in rural America – providing stability to these important community lifelines.

The CARE Act addresses several of the most common discrepancies which CAHs encounter:

  • Emergency Room Physician Availability Cost Time Study Methodology
  • Certified Registered Nurse Anesthetist (CRNA) Standby Time
  • Provider Fees/Taxes on a State-by-State Basis

Contact your Members of Congress and tell them to support H.R. 3224 today. Find your members of Congress here.

If you have any questions about the CARE Act, reach out to the CAH Coalition at contact@cahcoalition.com.


Critical Access Hospitals (CAHs) act as safety-net providers in rural and frontier communities – delivering inpatient and outpatient services, as well as 24-hour emergency care. Congress developed the Critical Access Hospital (CAH) designation to alleviate the financial strain placed on rural hospitals after an influx of hospital closures occurred in the 1980s and 1990s. Certification allows CAHs to receive cost-based reimbursement from Medicare, instead of standard fixed reimbursement rates. This reimbursement has been shown to enhance the financial performance of small rural hospitals that were losing money prior to CAH conversion and thus reduce hospital closures. CAHs make it possible for individuals living with complex medical needs to remain in their communities without traveling long distances to receive the care they require.