Hoeven, Fedorchak introduce legislation extending FCHIP to improve health care in rural areas

September 23, 2026 Press Release Bicameral Legislation Provides Flexibility & Increased Reimbursement under Medicare, Benefiting Critical Access Hospitals WASHINGTON – Senator John Hoeven (R-N.D.) and Congresswoman Julie Fedorchak (R-N.D.) today introduced legislation to extend the Frontier Community Health Integration Project (FCHIP) for five years. The FCHIP program develops and tests health care delivery and reimbursement models for Critical Access Hospitals (CAH) in hyper-rural counties to improve health outcomes for patients and save Medicare costs. In the Senate, the legislation is cosponsored by Senators Kevin Cramer (R-N.D.), Tim Sheehy (R-Mont.) and Steve Daines (R-Mont.). Currently there are five CAHs participating in the program, including the following North Dakota CAHs: Jacobson Memorial Hospital Care Center in Elgin. McKenzie County Healthcare Systems in Watford City. Southwest Healthcare Services in Bowman. “Critical Access Hospitals play a key role in ensuring that North Dakotans, regardless of their zip code, have improved access and better health care services. Our bicameral legislation extends this demonstration program for five years to help strengthen the care available to Medicare beneficiaries in rural areas while helping find ways to save on Medicare costs,” said Senator Hoeven. “North Dakotans should be able to get quality care close to home, even in our most rural of communities,” said Congresswoman Fedorchak. “Critical Access Hospitals are lifelines for rural families. Extending FCHIP will give participating hospitals more flexibility to provide skilled nursing care, expand telehealth, and sustain ambulance services. I’m glad to partner with Senator Hoeven on a practical way to strengthen rural health care while testing ways to save Medicare dollars.” “For families across rural America, having access to a local health care provider can make all the difference,” said Senator Cramer. “But low patient volumes and government restrictions can make it difficult for rural hospitals to keep their doors open and provide the care their communities need. Our bill to extend the FCHIP Demonstration will give rural hospitals greater flexibility to deliver essential services and help preserve access to quality health care for families in rural North Dakota.” “Since 2016, the Frontier Community Health Integration Project (FCHIP) has provided Montana’s Critical Access Hospitals with unique flexibility, allowed them to implement critical innovations, and improved access to and quality of care in rural areas. By keeping some of our most rural hospitals afloat through innovative payment models that enable community-based care, the program has served Montanans that might otherwise be overlooked. I strongly support extending FCHIP and am proud to cosponsor this crucial legislation,” said Senator Sheehy. “Montanans deserve access to top-quality health care, no matter where they live. Oftentimes, our rural communities face challenges in delivering that care- that’s why I’m proud to work with Senator Hoeven to extend the Frontier Community Health Integration Program (FCHIP) which will help Montana’s Critical Access Hospitals continue to test new ways to ensure access to high quality care in rural communities,” said Senator Daines. Specifically, FCHIP provides a waiver to Medicare payment rules that allows hospitals to increase the number of available Skilled Nursing Facility or Nursing Facility beds, cover the costs required to facilitate and grow telehealth programs and pay the expenses of providing ambulance services at each participating Critical Access Hospital. The legislation is endorsed by the National Rural Health Association, North Dakota Hospital Association, and the Montana Hospital Association. Issues : Health