1. Short title This Act may be cited as the Preserving Emergency Access in Key Sites Act or the PEAKS Act . 2. Treatment of hospitals that met mountainous terrain or secondary roads distance requirement for designation as critical access hospital Section 1820(h) of the Social Security Act ( 42 U.S.C. 1395i–4(h) ) is amended by adding at the end the following new paragraph: (4) Treatment of hospitals that met mountainous terrain or secondary roads distance requirement for designation (A) In general In the case of a hospital described in subparagraph (B), the hospital shall be deemed to meet the 15-mile distance requirement for mountainous terrain or secondary roads described in subsection (c)(2)(B)(i)(I) on or after January 1, 2026. (B) Hospital described A hospital described in this subparagraph is a hospital that— (i) as of the date of enactment of this paragraph, is designated as a critical access hospital; (ii) demonstrates (in a manner determined by the Secretary) that the hospital met the 15-mile distance requirement for mountainous terrain or secondary roads described in subsection (c)(2)(B)(i)(I) as of the hospital's last certification as a critical access hospital; and (iii) after such date of enactment, has a new hospital or other facility described in this subsection located within 10–15 miles of the hospital. (C) Regulations Not later than 1 year after the date of enactment of this paragraph, the Secretary shall promulgate regulations to carry out this paragraph. . 3. Modification of distance requirements for ambulance services furnished by critical access hospitals Section 1834(l)(8) of the Social Security Act ( 42 U.S.C. 1395m(l)(8) ) is amended, in the flush matter following subparagraph (B), by inserting (or, for such services furnished on or after January 1, 2025, in the case of mountainous terrain or in areas with only secondary roads available, a 15-mile drive) after 35-mile drive .