The PEAKS Act protects rural hospitals that serve remote areas by letting them keep their special "critical access hospital" status even if new hospitals open nearby. Critical access hospitals are smaller facilities in hard-to-reach places that get extra Medicare funding to stay open and serve their communities. Right now, if a new hospital opens within 15 miles of an existing critical access hospital in a mountainous or rural area, the older hospital can lose its special status. This bill says that won't happen—hospitals that already have this designation and can prove they qualified for it based on distance will keep it, even if another hospital opens within 10-15 miles of them after this law passes (starting January 1, 2026). The bill also makes a small change to ambulance services: it allows critical access hospitals in mountainous areas or places with only back roads to count a 15-mile drive as the distance standard for ambulance coverage, instead of the usual 35-mile requirement. This recognizes that in remote terrain, a 15-mile drive can take much longer than in flat areas. Essentially, this law helps ensure that rural hospitals in difficult-to-reach places don't lose funding and support just because another facility opens nearby, keeping emergency care available in communities that might otherwise lose their hospital.