Stricken language would be deleted from and underlined language would be added to present law.
Act 59 of the Regular Session
1 State of Arkansas As Engrossed: H2/1/23
2 94th General Assembly A Bill
3 Regular Session, 2023 HOUSE BILL 1127
4
5 By: Representative L. Johnson
6 By: Senator Irvin
7
8 For An Act To Be Entitled
9 AN ACT TO CREATE THE RURAL EMERGENCY HOSPITAL ACT; TO
10 AUTHORIZE LICENSURE OF RURAL EMERGENCY HOSPITALS BY
11 THE DEPARTMENT OF HEALTH; TO DECLARE AN EMERGENCY;
12 AND FOR OTHER PURPOSES.
13
14
15 Subtitle
16 TO CREATE THE RURAL EMERGENCY HOSPITAL
17 ACT; TO AUTHORIZE THE LICENSURE OF RURAL
18 EMERGENCY HOSPITALS BY THE DEPARTMENT OF
19 HEALTH; AND TO DECLARE AN EMERGENCY.
20
21
22 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF ARKANSAS:
23
24 SECTION 1. DO NOT CODIFY. Title.
25 This act shall be known and may be cited as the "Rural Emergency
26 Hospital Act".
27
28 SECTION 2. DO NOT CODIFY. Legislative findings and intent.
29 (a) The General Assembly finds that the importance and necessity of
30 providing and regulating the system by which healthcare services are
31 structured and integrated promotes the availability of and access to
32 necessary and appropriate healthcare services to protect the general health,
33 safety, and welfare of the rural residents of this state.
34 (b) It is the intent of the General Assembly to create a category of
35 licensure to enable certain hospitals within this state to receive federal
36 healthcare reimbursement as rural emergency hospitals in order to:
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1 (1) Improve the health of the rural population of this state;
2 (2) Preserve access to healthcare services and providers;
3 (3) Encourage collaboration among healthcare providers;
4 (4) Promote delivery of quality rural healthcare services and
5 the efficiency and efficacy of rural healthcare services;
6 (5) Embrace technology in the delivery of rural healthcare
7 services; and
8 (6) Promote adequate and fair reimbursement for rural healthcare
9 services.
10
11 SECTION 3. Arkansas Code § 20-9-201, concerning definitions relating
12 to health facilities, is amended to add additional subdivisions to read as
13 follows:
14 (13) “Rural emergency hospital” means an establishment that:
15 (A) Meets the eligibility requirements described in this
16 subchapter;
17 (B) Provides rural emergency hospital services;
18 (C) Provides rural emergency services in the facility
19 twenty-four (24) hours per day by maintaining an emergency department that is
20 staffed twenty-four (24) hours per day and seven (7) days per week with a
21 physician, nurse practitioner, clinical nurse specialist, or physician
22 assistant;
23 (D) Has a transfer agreement in effect with a Level I or
24 Level II trauma center; and
25 (E) Meets other requirements as the Department of Health
26 finds necessary:
27 (i) In the interest of the health and safety of
28 individuals who receive rural emergency hospital services; and
29 (ii) For implementation of a state licensure that
30 satisfies requirements for reimbursement by federal healthcare programs as a
31 rural emergency hospital; and
32 (14) “Rural emergency hospital services” means the following
33 services provided by a rural emergency hospital that do not require more than
34 twenty-four (24) hours on average in a rural emergency hospital:
35 (A) Emergency department services and observation care;
36 and
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1 (B) At the election of the rural emergency hospital, other
2 medical and health services provided on an outpatient basis as specified in
3 regulations adopted by the United States Secretary of Health and Human
4 Services and authorized by the Department of Health.
5
6 SECTION 4. Arkansas Code § 20-9-214(b), concerning fees for the
7 issuance of healthcare facility licenses, is amended to read as follows:
8 (b) The Department of Health may levy and collect the following annual
9 fees for issuance of an annual license to hospitals or institutions:
10
11 Per facility FY '98 FY '99
12 (unless otherwise noted)
13 (1) Hospitals (per bed) $ 4.00 $ 6.00
14 (2) Ambulatory Surgery Center 1,000.00 1,000.00
15 (3) Rural Emergency Hospital 500.00
16 (3)(4) Hospital-Based Recuperation Center 160.00 275.00
17 (4)(5) Freestanding Recuperation Center 2,000.00 2,000.00
18 (5)(6) Hospital-Based Alcohol/Drug Unit 60.00 75.00
19 (6)(7) Freestanding Alcohol/Drug Unit 1,000.00 1,000.00
20 (7)(8) Hospital-Based Outpatient Psychiatric Center 60.00 75.00
21 (8)(9) Freestanding Outpatient Psychiatric Center 1,000.00 1,000.00
22 (9)(10) Infirmary 100.00 100.00
23 (10)(11) Reissuance of license due to name/address change 100.00 100.00
24
25 SECTION 5. Arkansas Code Title 20, Chapter 9, Subchapter 2, is amended
26 to add an additional section to read as follows:
27 20-9-224. Rural emergency hospitals.
28 (a) A healthcare facility shall be eligible to apply for a rural
29 emergency hospital license if the healthcare facility on or before December
30 27, 2020, was a:
31 (1) Licensed critical access hospital;
32 (2) General hospital with not more than fifty (50) licensed beds
33 located in a county in a rural area under 42 U.S.C. § 1395ww(d)(10)(C)(ii);
34 or
35 (3) General hospital with not more than fifty (50) licensed beds
36 that is deemed as being located in a rural area under 42 U.S.C. §
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1 1395ww(d)(8)(E).
2 (b) A healthcare facility applying for licensure as a rural emergency
3 hospital shall include with the licensure application:
4 (1) An action plan for initiating rural emergency hospital
5 services, including a detailed transition plan that lists the specific
6 services that the healthcare facility shall retain, modify, add, or
7 discontinue, or any combination of retain, modify, add, or discontinue;
8 (2) A description of services that the healthcare facility
9 intends to provide on an outpatient basis; and
10 (3) Other information as required by rules adopted by the
11 Department of Health.
12 (c) A rural emergency hospital shall not have inpatient beds unless
13 the rural emergency hospital has a unit that is a distinct part of the rural
14 emergency hospital that
15 (1) Is licensed as a skilled nursing facility to provide post-
16 hospital extended care services; or
17 (2) Provides behavioral health services in accordance with the
18 Arkansas Health and Opportunity for Me Act of 2021, § 23-61-1001 et seq.
19 (d) A rural emergency hospital may own and operate an entity that
20 provides ambulance services.
21 (e)(1) A licensed general hospital or critical access hospital that
22 applies for and receives licensure as a rural emergency hospital and elects
23 to operate as a rural emergency hospital shall retain its original license as
24 a general hospital or critical access hospital.
25 (2) The original license shall remain inactive while the rural
26 emergency hospital license is in effect.
27 (f)(1) A rural emergency hospital, including a city, county, or other
28 governmental or quasi-governmental hospital, may enter into any contracts
29 required to be eligible for federal reimbursement as a rural emergency
30 hospital.
31 (2)(A) An entity engaging in activities and entering into
32 contracts required to meet the requirements for licensure and reimbursement
33 as a rural emergency hospital and its officers, agents, representatives,
34 employees, and directors are acting pursuant to clearly expressed state
35 policy under the supervision of the state.
36 (B) An entity is not subject to state or federal antitrust
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1 laws while acting in this manner.
2 (g) The State Board of Health shall adopt rules establishing the
3 minimum standards for the establishment and operation of rural emergency
4 hospitals in accordance with this section, including licensure of rural
5 emergency hospitals.
6 (h)(1) A health benefit plan that is offered, issued, or renewed in
7 this state shall provide benefits and coverage for services performed by a
8 rural emergency hospital if the services would be covered under the health
9 benefit plan if performed by a general hospital.
10 (2) As used in subdivision (h)(1) of this section, "health
11 benefit plan" means the same as defined in § 23-79-1801.
12 (i) The Arkansas Medicaid Program shall reimburse a rural emergency
13 hospital at the same or greater rate in which critical access hospitals are
14 reimbursed.
15
16 SECTION 6. EMERGENCY CLAUSE. It is found and determined by the
17 General Assembly of the State of Arkansas that rural hospitals in Arkansas
18 are in financial distress; that the designation of a rural emergency hospital
19 created by the United States government can provide much needed financial
20 relief to rural hospitals in Arkansas by providing access to enhanced
21 reimbursement codes; and that this act is immediately necessary to keep rural
22 hospitals in this state open and avoid the immediate risk of closure of rural
23 hospitals that help preserve the health of the citizens of this state as well
24 as to preserve the healthcare infrastructure in Arkansas. Therefore, an
25 emergency is declared to exist, and this act being immediately necessary for
26 the preservation of the public peace, health, and safety shall become
27 effective on:
28 (1) The date of its approval by the Governor;
29 (2) If the bill is neither approved nor vetoed by the Governor,
30 the expiration of the period of time during which the Governor may veto the
31 bill; or
32 (3) If the bill is vetoed by the Governor and the veto is
33 overridden, the date the last house overrides the veto.
34
35 /s/L. Johnson
36 APPROVED: 2/13/23
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Statutes affected:
Old version HB1127 V2 - 2-1-2023 09:16 AM: 20-9-201, 20-9-214(b)
HB 1127: 20-9-201, 20-9-214(b)
Act 59: 20-9-201, 20-9-214(b)