Comment on CMS-2026-1256-0002

Summary: The National Rural Health Association (NRHA) opposes several proposed changes that they argue will disproportionately harm rural hospitals, specifically the reduction in uncompensated care payments, the expansion of the CJR-X model to mandatory participation, and the inclusion of Medicare Advantage data in quality reporting. They advocate for payment adjustments to account for low case-mix indices, the preservation of existing referral-based location criteria, and the expansion of the Rural Community Hospital Demonstration (RCHD) program.