This bill amends the Social Security Act to impose new limitations on the geographic reclassification of hospitals under the Medicare program, particularly concerning their designation as rural. It restricts the criteria under which an urban hospital can be treated as rural for Medicare payment purposes, especially for applications submitted on or after October 1, 2026 . The legislation also specifies that certain statutory designations for rural status must have been in effect as of January 1, 2026 , to remain valid for reclassification. A key provision mandates that by October 1, 2029 , hospitals currently treated as rural under specific statutory provisions must re-demonstrate their eligibility based on updated criteria. Furthermore, the bill prevents hospitals from receiving dual reclassification benefits. Starting October 1, 2026 , the Medicare Geographic Classification Review Board is prohibited from approving reclassification applications for hospitals already treated as rural under statutory provisions, ensuring that hospitals cannot simultaneously benefit from both a statutory rural designation and a Board-approved reclassification.