[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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