1. Short title This Act may be cited as the Assistance for Rural Community Hospitals Act or the ARCH Act . 2. Extending Medicare-dependent hospital and Medicare low-volume hospital payments (a) MDH extension (1) Extension of payment methodology Section 1886(d)(5)(G) of the Social Security Act ( 42 U.S.C. 1395ww(d)(5)(G) ) is amended— (A) in clause (i), by striking October 1, 2024 and inserting October 1, 2029 ; and (B) in clause (ii)(II), by striking October 1, 2024 and inserting October 1, 2029 . (2) Conforming amendments (A) Extension of target amount Section 1886(b)(3)(D) of the Social Security Act ( 42 U.S.C. 1395ww(b)(3)(D) ) is amended— (i) in the matter preceding clause (i), by striking October 1, 2024 and inserting October 1, 2029 ; and (ii) in clause (iv), by striking fiscal year 2024 and inserting fiscal year 2029, . (B) Permitting hospitals to decline reclassification Section 13501(e)(2) of the Omnibus Budget Reconciliation Act of 1993 ( 42 U.S.C. 1395ww note) is amended by striking fiscal year 2024 and inserting fiscal year 2029, . (b) LVH extension Section 1886(d)(12) of the Social Security Act ( 42 U.S.C. 1395ww(d)(12) ) is amended— (1) in subparagraph (C)(i)— (A) in the matter preceding subclause (I), by striking through 2024 and inserting through 2029 ; (B) in subclause (III), by striking through 2024 and inserting through 2029 ; and (C) in subclause (IV), by striking 2025 and inserting 2030 ; and (2) in subparagraph (D)— (A) in the matter preceding clause (i), by striking through 2024 and inserting through 2029