This legislation aims to reauthorize and extend the vital rural community hospital demonstration program, which provides crucial support to healthcare facilities in underserved areas. The primary provision of the bill amends the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 to change the program's extension period from an additional 15 years to an additional 20 years . The bill includes several conforming amendments to reflect this extended timeframe across various subsections of the original act. Furthermore, it directs the Secretary to apply specific provisions to rural community hospitals that are not original participants but are actively involved in the demonstration program between December 30, 2024, and January 1, 2027, during the fourth five years of the newly extended period, ensuring broader eligibility and continued benefits.