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<bill bill-stage="Introduced-in-Senate" dms-id="A1" public-private="public" slc-id="S1-KEL24346-32N-XJ-LNP"><metadata xmlns:dc="http://purl.org/dc/elements/1.1/">
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<dc:title>118 S4322 IS: Rural Emergency Hospital Designation Improvement Act</dc:title>
<dc:publisher>U.S. Senate</dc:publisher>
<dc:date>2024-05-14</dc:date>
<dc:format>text/xml</dc:format>
<dc:language>EN</dc:language>
<dc:rights>Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain.</dc:rights>
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<distribution-code display="yes">II</distribution-code><congress>118th CONGRESS</congress><session>2d Session</session><legis-num>S. 4322</legis-num><current-chamber>IN THE SENATE OF THE UNITED STATES</current-chamber><action><action-date date="20240514">May 14, 2024</action-date><action-desc><sponsor name-id="S347">Mr. Moran</sponsor> (for himself and <cosponsor name-id="S394">Ms. Smith</cosponsor>) introduced the following bill; which was read twice and referred to the <committee-name committee-id="SSFI00">Committee on Finance</committee-name></action-desc></action><legis-type>A BILL</legis-type><official-title>To amend title XVIII of the Social Security Act to make improvements relating to the designation of rural emergency hospitals.</official-title></form><legis-body><section id="S1" section-type="section-one"><enum>1.</enum><header>Short title</header><text display-inline="no-display-inline">This Act may be cited as the <quote><short-title>Rural Emergency Hospital Designation Improvement Act</short-title></quote>.</text></section><section commented="no" display-inline="no-display-inline" id="id4e510411a6854b65aaed092d8b049520"><enum>2.</enum><header>Eligibility changes</header><subsection commented="no" display-inline="no-display-inline" id="idb41fd835a2ea4e76b8efb2509be658f8"><enum>(a)</enum><header display-inline="yes-display-inline">In general</header><text display-inline="yes-display-inline">Section 1861(kkk)(3) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395x">42 U.S.C. 1395x(kkk)(3)</external-xref>) is amended, in the matter preceding subparagraph (A), by striking <quote>as of</quote> and inserting <quote>at any point during the period beginning on January 1, 2015, and ending on</quote>.</text></subsection><subsection id="idec110978ce5f402790d668624788fc8b"><enum>(b)</enum><header>Waiver of certain requirements</header><text>Section 1861(kkk)(3) of the Social Security (<external-xref legal-doc="usc" parsable-cite="usc/42/1395x">42 U.S.C. 1395x(kkk)(3)</external-xref>, as amended by subsection (a), is amended—</text><paragraph commented="no" display-inline="no-display-inline" id="id8af57533af7d4c2d99db63a49642573c"><enum>(1)</enum><text display-inline="yes-display-inline">by redesignating subparagraphs (A) and (B) as clauses (i) and (ii), respectively;</text></paragraph><paragraph commented="no" display-inline="no-display-inline" id="id8387603579f34cd384ee17a44bb01b48"><enum>(2)</enum><text>by striking <quote><header-in-text style="OLC" level="paragraph">described</header-in-text>.—A facility</quote> and inserting “<header-in-text level="paragraph" style="OLC">described</header-in-text>.—</text><quoted-block style="OLC" display-inline="no-display-inline" id="idF6A062CE661C48278FE7DA085CBF1872"><subparagraph commented="no" display-inline="no-display-inline" id="id58b91240a8cb4cbd997e63cf1eb158b1"><enum>(A)</enum><header>In general</header><text display-inline="yes-display-inline">Subject to subparagraph (B), a facility</text></subparagraph><after-quoted-block>; and</after-quoted-block></quoted-block></paragraph><paragraph commented="no" display-inline="no-display-inline" id="id8e14aeb22121454bba47b9c1ef76db90"><enum>(3)</enum><text display-inline="yes-display-inline">by adding at the end the following new subparagraph:</text><quoted-block style="OLC" display-inline="no-display-inline" id="idDBC8503C1E8C4A28A46DBE6C7795BEC3"><subparagraph commented="no" display-inline="no-display-inline" id="id3b917abcb0dd44c59ace91f5e91646e2"><enum>(B)</enum><header>Waiver</header><text display-inline="yes-display-inline">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.</text></subparagraph><after-quoted-block>.</after-quoted-block></quoted-block></paragraph></subsection></section><section id="idc94f1ebaf694499f9cb28a33ab4b98bf"><enum>3.</enum><header>Distinct part units</header><text display-inline="no-display-inline">Section 1861(kkk)(6) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395x">42 U.S.C. 1395x(kkk)(6)</external-xref>) is amended—</text><paragraph commented="no" display-inline="no-display-inline" id="id9799aee8b6c749108ae8d513689e6535"><enum>(1)</enum><text>in subparagraph (A), by striking <quote>and</quote> at the end;</text></paragraph><paragraph commented="no" display-inline="no-display-inline" id="idd31b3bf7e07d4bacb093cdd87ed90452"><enum>(2)</enum><text display-inline="yes-display-inline">in subparagraph (B), by striking the period at the end and inserting a semicolon; and</text></paragraph><paragraph commented="no" display-inline="no-display-inline" id="id214459bde6c740d6a3787c3f0862b78a"><enum>(3)</enum><text display-inline="yes-display-inline">by adding at the end the following new subparagraphs:</text><quoted-block style="OLC" display-inline="no-display-inline" id="id832D4230B5904C03AD6C16940D43C78E"><subparagraph commented="no" display-inline="no-display-inline" id="id00ffbade3a2a410f89e7462a03e07f8b"><enum>(C)</enum><text display-inline="yes-display-inline">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;</text></subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="id93581a7951db4f5da3ef6406907bb7c1"><enum>(D)</enum><text display-inline="yes-display-inline">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</text></subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="id1dc4be1aa4574a84afd76567a7ae0da7"><enum>(E)</enum><text display-inline="yes-display-inline">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.</text></subparagraph><after-quoted-block>.</after-quoted-block></quoted-block></paragraph></section><section id="idc0423f517b2c4247bbdcba7ea88dec63"><enum>4.</enum><header>Add-on payment for diagnostic laboratory tests</header><text display-inline="no-display-inline">Section 1834(x)(1) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395m">42 U.S.C. 1395m(x)(1)</external-xref>) is amended—</text><paragraph commented="no" display-inline="no-display-inline" id="id5f3a3aaa7f0f4ae09d8d18abba2c98ee"><enum>(1)</enum><text display-inline="yes-display-inline">by striking <quote><header-in-text style="OLC" level="paragraph">hospitals</header-in-text>.—</quote> and all that follows through <quote>In the case</quote> and inserting “<header-in-text level="paragraph" style="OLC">hospitals</header-in-text>.—</text><quoted-block style="OLC" display-inline="no-display-inline" id="idFFA1A187DEA142DF905086FA1549BACC"><paragraph commented="no" display-inline="no-display-inline" id="id4ab7c4dedfd74348a957f4446ca64a53"><enum>(1)</enum><header>In general</header><subparagraph commented="no" display-inline="no-display-inline" id="idee5e708d814342fb85e87711f8263b9d"><enum>(A)</enum><header display-inline="yes-display-inline">Payment for rural emergency hospital services</header><text display-inline="yes-display-inline">In the case</text></subparagraph></paragraph><after-quoted-block>; and</after-quoted-block></quoted-block></paragraph><paragraph commented="no" display-inline="no-display-inline" id="id8644ba8694bd42959912ad7f3c89e23c"><enum>(2)</enum><text>by adding at the end the following new subparagraph:</text><quoted-block style="OLC" display-inline="no-display-inline" id="id3ABBA6A6E9DA4F57AEA8DA846DD1ED9F"><subparagraph commented="no" display-inline="no-display-inline" id="ida77df87497314f6ea3896c80a48c7a44"><enum>(B)</enum><header>Payment for diagnostic laboratory tests</header><text>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</text></subparagraph><after-quoted-block>.</after-quoted-block></quoted-block></paragraph></section><section id="idc1c5107de132444e85f8642b928390e6"><enum>5.</enum><header>Swing beds</header><text display-inline="no-display-inline">Section 1861(kkk)(6) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395x">42 U.S.C. 1395x(kkk)(6)</external-xref>), as amended by section 3, is amended—</text><paragraph commented="no" display-inline="no-display-inline" id="id4ce5a969ede04b3f8b84c4c2770a4b88"><enum>(1)</enum><text>in subparagraph (B), by striking <quote>and</quote> at the end;</text></paragraph><paragraph commented="no" display-inline="no-display-inline" id="id450b0fcd333a4e82851e8c325f423e6a"><enum>(2)</enum><text display-inline="yes-display-inline">in subparagraph (C), by striking the period at the end and inserting <quote>; and</quote>; and</text></paragraph><paragraph commented="no" display-inline="no-display-inline" id="id1510de6956544ca79fed87ee3dc6a557"><enum>(3)</enum><text display-inline="yes-display-inline">by adding at the end the following new subparagraph:</text><quoted-block style="OLC" display-inline="no-display-inline" id="idDE7E4A6E4DB44BDB940DDF282CF6662B"><subparagraph commented="no" display-inline="no-display-inline" id="idc39a56eb4c574861b2be202e299511e7"><enum>(D)</enum><text display-inline="yes-display-inline">may enter into an agreement described in section 1883.</text></subparagraph><after-quoted-block>.</after-quoted-block></quoted-block></paragraph></section><section id="id52825bd282f54f06a7ebab4b07c6fcd3"><enum>6.</enum><header>Necessary provider status for facilities that revert to critical access hospital designation</header><text display-inline="no-display-inline">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 (<external-xref legal-doc="usc" parsable-cite="usc/42/1395x">42 U.S.C. 1395x(kkk)(2)</external-xref>)) that reverts back to its previous designation as a critical access hospital (as defined in section 1861(mm)(1) of such Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395x">42 U.S.C. 1395x(m)</external-xref>)) to regain its status as a necessary provider of health care services pursuant to section 1820(c)(2)(B)(i)(II) of such Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395i-4">42 U.S.C. 1395i–4(c)(2)(B)(i)(II)</external-xref>), 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.</text></section><section id="idEDE4245F23D547838963571C2CB61FA2"><enum>7.</enum><header>National Health Service Corps Site Eligibility</header><text display-inline="no-display-inline">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 (<external-xref legal-doc="usc" parsable-cite="usc/42/1395x">42 U.S.C. 1395x(kkk)(2)</external-xref>)) to be a health professional shortage area in accordance with section 332(a)(1)(C) of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/254e">42 U.S.C. 254e(a)(1)(C)</external-xref>).</text></section><section id="id00d8544874ea41aea7a4b52d754adef6"><enum>8.</enum><header>Small rural hospital improvement program grants</header><text display-inline="no-display-inline">Section 1820(g) of the Social Security Act (42 U.S.C. <external-xref legal-doc="usc" parsable-cite="usc/42/1395i-4">42 U.S.C. 1395i–4(g)</external-xref>) is amended—</text><paragraph id="ida6bc94da5b464d9a92786151e56adf9e"><enum>(1)</enum><text>in paragraph (1)(D), by inserting <quote>or rural emergency hospitals (as defined in section 1861(kkk)(2))</quote> after <quote>critical access hospitals</quote>; and</text></paragraph><paragraph id="id8b6719ae8c124fe8bc9abb9f084c4ef4"><enum>(2)</enum><text>in paragraph (3)(A), by inserting <quote>or rural emergency hospitals (as defined in section 1861(kkk)(2))</quote> after <quote>small rural hospitals</quote>.</text></paragraph></section></legis-body></bill> 

