PIERRE, S.D. (AP) — A South Dakota official says 26 rural hospitals in the state are threatened by a federal agency's proposal that could eliminate the extra payments those hospitals get for service to Medicare patients.

State Health Secretary Doneen Hollingsworth says she doubts the proposal will be approved, but South Dakota will fight the proposed change in the way rural facilities are designated as critical access hospitals. She says if the proposal is approved, it could cause some rural hospitals to close.

Critical access hospitals get reimbursed for 101 percent of their costs of treating Medicare patients, a much higher payment than larger hospitals get. A federal agency has proposed a change that could take away the higher payments for some hospitals less than 35 miles from other hospitals.

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