The Rural Hospital Fairness Act proposes to amend the Social Security Act, specifically Medicare's provisions for Critical Access Hospitals (CAHs). Its primary goal is to enable certain rural hospitals to maintain their CAH designation , even if they no longer fully meet specific location requirements for such facilities. Under this bill, a facility can continue to be deemed a CAH if it was originally designated before January 1, 2002 , and was still certified by the Secretary as of December 31, 2024 . A crucial condition for this continuation is that, at the time of official decertification, the hospital must have been the only hospital, CAH, or rural emergency hospital in its county or equivalent local government unit. This measure aims to preserve essential healthcare access in underserved rural areas by preventing the loss of CAH status for long-standing facilities.