Critical Access Hospital Flexibility Act of 2009 - Amends title XVIII (Medicare) of the Social Security Act with respect to state Medicare rural hospital flexibility programs, in particular the criteria for designation of critical access hospitals.
Revises requirements for the counting of beds for purposes of determining whether a hospital may be designated as a critical access hospital. Allows a facility to provide a maximum of 20 (currently 25) acute care inpatient beds, as determined on an annual, average basis. Declares that only occupied beds shall be counted.
Exempts from the critical access hospital inpatient bed limitation beds provided to certain veterans.
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