1. Short title This Act may be cited as the Rural Hospital Closure Relief Act of 2019 . 2. Restoring State authority to waive the 35-mile rule for certain Medicare critical access hospital designations Section 1820 of the Social Security Act ( 42 U.S.C. 1395i–4 ) is amended— (1) in subsection (c)(2)— (A) in subparagraph (B)(i)— (i) in subclause (I), by striking at the end or ; (ii) in subclause (II), by inserting at the end or ; and (iii) by adding at the end the following new subclause: (III) subject to subparagraph (G), is a hospital described in subparagraph (F) and is certified on or after the date of the enactment of the Rural Hospital Closure Relief Act of 2019 by the State as being a necessary provider of health care services to residents in the area; ; and (B) by adding at the end the following new subparagraphs: (F) Hospital described For purposes of subparagraph (B)(i)(III), a hospital described in this subparagraph is a hospital that— (i) is a sole community hospital (as defined in section 1886(d)(5)(D)(iii)), a medicare dependent, small rural hospital (as defined in section 1886(d)(5)(G)(iv)), a low-volume hospital that in 2019 receives a payment adjustment under section 1886(d)(12), or a subsection (d) hospital (as defined in section 1886(d)(1)(B)) that has fewer than 50 beds; (ii) is located in a rural area, as defined by the Secretary, based on the most recent rural urban commuting area code (or its successor criteria) as set forth by the Office of Management and Budget; (iii) as determined by the Secretary, serves a patient population— (I) with a high percentage, relative to the national or statewide average, of individuals with income that is below 150 percent of the poverty line; (II) in a health professional shortage area (as defined in section 332(a)(1)(A) of the Public Health Service Act)