SESSION OF 2024
SUPPLEMENTAL NOTE ON HOUSE SUBSTITUTE FOR
SENATE BILL NO. 219
As Recommended by House Committee on
Health and Human Services

Brief*
House Sub. for SB 219 would expand the eligibility of
facilities regarding the licensure of rural emergency hospitals
(REHs).

Rural Emergency Hospital Licensure
The bill would expand eligibility for REH licensure to
facilities that were at any point during the period between
January 1, 2015, and December 26, 2020, one of the
following types of facilities:
● Licensed critical access hospital;
● General hospital with no more than 50 licensed
beds located in a county in a rural area as defined
in Section 1886(d)(2)(D) of the federal Social
Security Act;
● General hospital with no more than 50 licensed
beds that is deemed as being located in a rural
area pursuant to Section 1886(d)(8)(E) of the
federal Social Security Act; or
● A department of a provider or a provider-based
entity.

____________________
*Supplemental notes are prepared by the Legislative Research
Department and do not express legislative intent. The supplemental
note and fiscal note for this bill may be accessed on the Internet at
http://www.kslegislature.org
 The bill would define “provider-based entity” as a
provider of health care services or a rural health clinic that is
either created by, or acquired by, a main provider for the
purpose of furnishing health care services of a different type
from those of the main provider under the ownership and
administrative and financial control of the main provider (42
CFR § 413.65).
Current law provides for a licensed general hospital or
critical access hospital that applies for and receives licensure
as a REH and elects to operate as a REH to retain its original
license as a general hospital or critical access hospital. The
bill would expand this provision to cover provider-based
entities or provider departments.

Effective Date
The bill would provide for the Rural Emergency Hospital
Adjustment Act (S. 3394, 118th Cong. (2023)), if enacted into
law, to have its passage certified by the Attorney General to
the Secretary of State. Upon receipt of the certification, the
Secretary would publish the certification in the Kansas
Register, and the bill would then be in effect upon its
publication in the Kansas Register.

Background
The House Committee on Health and Human Services
recommended a substitute bill incorporating provisions
pertaining to REH licensure (provisions of HB 2637, as
introduced). The original provisions of SB 219 were removed
from the bill. The background information on HB 2637 is
detailed below.
[Note: SB 219, as recommended by the Senate
Committee on Public Health and Welfare during the 2023
Legislative Session, would have amended the Health Care
Provider Insurance Availability Act to add facilities where

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elective abortions are performed to the list of entities that are
not health care providers, which would make such facilities
ineligible to purchase professional liability insurance from the
Health Care Stabilization Fund. These provisions were later
added by the Senate Committee on Public Health and
Welfare to HB 2325. The House concurred with amendments
to HB 2325, and the bill was passed by the Legislature but
vetoed by the Governor. The motion to override was
successful in the House, but the veto was sustained in the
Senate.]

HB 2637 – Rural Emergency Hospital Licensure
The bill was introduced by the House Committee on
Health and Human Services at the request of Representative
Bryce on behalf of the Kansas Hospital Association (KHA).
House Committee on Health and Human Services
In the House Committee hearing, a representative of
KHA provided proponent testimony, stating the bill would
ensure Kansas is ready to take advantage of any new
flexibilities regarding REH licensure if they are provided at the
federal level. The representative stated the bill would allow
hospitals that have closed since 2015 the opportunity to
reopen as REHs. The conferee noted the legislation would
potentially affect five hospitals in Kansas, but it would not
force any hospitals to adopt REH licensure and would not
prevent them from changing to another designation in the
future.
Written-only proponent testimony was provided by
representatives of Ascension Via Christi Pittsburg, Kansas
Medical Society, and the League of Kansas Municipalities.
No other testimony was provided.


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House Committee of the Whole
The House Committee of the Whole amended the bill to
require facilities eligible for REH licensure to be located at
least 35 miles from an existing hospital. On final action, the
bill, as amended, was not passed. [Note: This amendment
was not retained by the House Committee of Health and
Human Services when the Committee placed the contents of
HB 2637 in SB 219 on February 28, 2024.]
Fiscal Information
According to the fiscal note prepared by the Division of
the Budget on HB 2637, as introduced, the Kansas
Department of Health and Environment reports that
enactment of the bill would not have a fiscal effect on the
agency and states the bill would supersede Centers of
Medicare and Medicaid Services authority. The Office of the
Attorney General notes the Office of the Medicaid Inspector
General and Medicaid Fraud Control Unit would have the
authority to audit and investigate the facilities referenced in
the bill, but any additional reviews stemming from the bill
would be handled within existing resources.
The Office of the Secretary of State states passage of
the bill would not have a significant fiscal impact on the
agency but notes the charge to publish the required
certification in the Kansas Register would be $7.00 per
column inch. The agency notes that generally, it is a minimum
of two column inches, or $14.00, to publish text. The cost
range charged would depend on several factors, but printing
can be omitted if it would be too expensive, cumbersome, or
otherwise inexpedient. In those cases, the agency could
provide a webpage link or reference to the text in the Kansas
Register. Any fiscal effect associated with the bill is not
reflected in The FY 2025 Governor’s Budget Report.
Rural emergency hospital; licensure; hospitals


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Statutes affected:
As introduced: 40-3401, 39-923, 75-6102, 40-3403a
Version 2: 65-484