[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[S. 4322 Introduced in Senate (IS)]

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118th CONGRESS
  2d Session
                                S. 4322

 To amend title XVIII of the Social Security Act to make improvements 
       relating to the designation of rural emergency hospitals.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                              May 14, 2024

 Mr. Moran (for himself and Ms. Smith) introduced the following bill; 
     which was read twice and referred to the Committee on Finance

_______________________________________________________________________

                                 A BILL


 
 To amend title XVIII of the Social Security Act to make improvements 
       relating to the designation of rural emergency hospitals.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Rural Emergency Hospital Designation 
Improvement Act''.

SEC. 2. ELIGIBILITY CHANGES.

    (a) In General.--Section 1861(kkk)(3) of the Social Security Act 
(42 U.S.C. 1395x(kkk)(3)) is amended, in the matter preceding 
subparagraph (A), by striking ``as of'' and inserting ``at any point 
during the period beginning on January 1, 2015, and ending on''.
    (b) Waiver of Certain Requirements.--Section 1861(kkk)(3) of the 
Social Security (42 U.S.C. 1395x(kkk)(3), as amended by subsection (a), 
is amended--
            (1) by redesignating subparagraphs (A) and (B) as clauses 
        (i) and (ii), respectively;
            (2) by striking ``described.--A facility'' and inserting 
        ``described.--
                    ``(A) In general.--Subject to subparagraph (B), a 
                facility''; and
            (3) by adding at the end the following new subparagraph:
                    ``(B) Waiver.--Not later than one year after the 
                date of enactment of this subparagraph, the Secretary 
                shall promulgate regulations to waive subparagraph (A) 
                with respect to facilities that operate similarly to a 
                rural emergency hospital in order for such facilities 
                to be eligible for conversion to a rural emergency 
                hospital under this subsection.''.

SEC. 3. DISTINCT PART UNITS.

    Section 1861(kkk)(6) of the Social Security Act (42 U.S.C. 
1395x(kkk)(6)) is amended--
            (1) in subparagraph (A), by striking ``and'' at the end;
            (2) in subparagraph (B), by striking the period at the end 
        and inserting a semicolon; and
            (3) by adding at the end the following new subparagraphs:
                    ``(C) maintain or include a unit of the facility 
                that is a distinct part licensed as an inpatient 
                psychiatric unit for behavioral health patients and 
                allows for inpatient care;
                    ``(D) maintain or include a unit of the facility 
                that is a distinct part licensed as an inpatient 
                rehabilitation facility and allows for inpatient care; 
                and
                    ``(E) maintain or include a unit of the facility 
                that is a distinct part unit licensed as an obstetric 
                wing, labor and delivery unit, or obstetric emergency 
                department.''.

SEC. 4. ADD-ON PAYMENT FOR DIAGNOSTIC LABORATORY TESTS.

    Section 1834(x)(1) of the Social Security Act (42 U.S.C. 
1395m(x)(1)) is amended--
            (1) by striking ``hospitals.--'' and all that follows 
        through ``In the case'' and inserting ``hospitals.--
            ``(1) In general.--
                    ``(A) Payment for rural emergency hospital 
                services.--In the case''; and
            (2) by adding at the end the following new subparagraph:
                    ``(B) Payment for diagnostic laboratory tests.--In 
                the case of clinical diagnostic laboratory tests and 
                other diagnostic laboratory tests that are not covered 
                OPD services (as defined in section 1833(t)(1)(B)) 
                furnished by a rural emergency hospital (as defined in 
                section 1861(kkk)(2)) on or after January 1, 2025, the 
                amount of payment for such tests shall be equal to the 
                amount of payment that would otherwise apply under the 
                applicable fee schedule, increased by 5 percent to 
                reflect the higher costs incurred by such hospitals, 
                and shall include the application of any copayment 
                amount determined under this part as if such increase 
                had not occurred''.

SEC. 5. SWING BEDS.

    Section 1861(kkk)(6) of the Social Security Act (42 U.S.C. 
1395x(kkk)(6)), as amended by section 3, is amended--
            (1) in subparagraph (B), by striking ``and'' at the end;
            (2) in subparagraph (C), by striking the period at the end 
        and inserting ``; and''; and
            (3) by adding at the end the following new subparagraph:
                    ``(D) may enter into an agreement described in 
                section 1883.''.

SEC. 6. NECESSARY PROVIDER STATUS FOR FACILITIES THAT REVERT TO 
              CRITICAL ACCESS HOSPITAL DESIGNATION.

    Not later than one year after the date of the enactment of this 
Act, the Secretary of Health and Human Services shall promulgate 
regulations to permit a rural emergency hospital (as defined in section 
1861(kkk)(2) of the Social Security Act (42 U.S.C. 1395x(kkk)(2))) that 
reverts back to its previous designation as a critical access hospital 
(as defined in section 1861(mm)(1) of such Act (42 U.S.C. 1395x(m))) to 
regain its status as a necessary provider of health care services 
pursuant to section 1820(c)(2)(B)(i)(II) of such Act (42 U.S.C. 1395i-
4(c)(2)(B)(i)(II)), but only if the facility was designated as a 
necessary provider of health care services pursuant to such section 
prior to converting to a rural emergency hospital.

SEC. 7. NATIONAL HEALTH SERVICE CORPS SITE ELIGIBILITY.

    The Secretary of Health and Human Services, acting through the 
Administrator of the Health Resources and Services Administration, 
shall promulgate regulations to deem a rural emergency hospital (as 
defined in section 1861(kkk)(2) of the Social Security Act (42 U.S.C. 
1395x(kkk)(2))) to be a health professional shortage area in accordance 
with section 332(a)(1)(C) of the Public Health Service Act (42 U.S.C. 
254e(a)(1)(C)).

SEC. 8. SMALL RURAL HOSPITAL IMPROVEMENT PROGRAM GRANTS.

    Section 1820(g) of the Social Security Act (42 U.S.C. 42 U.S.C. 
1395i-4(g)) is amended--
            (1) in paragraph (1)(D), by inserting ``or rural emergency 
        hospitals (as defined in section 1861(kkk)(2))'' after 
        ``critical access hospitals''; and
            (2) in paragraph (3)(A), by inserting ``or rural emergency 
        hospitals (as defined in section 1861(kkk)(2))'' after ``small 
        rural hospitals''.
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