,,ii #aaith ,,congress #b;d ,session ,s4 #eafd ,,in ,,the ,,senate ,,of ,,the ,,united ,,states ,july #bi1 #bjbf,mr4 ,moran 7for himself1 ,ms4 ,smith1 ,mr4 ,tuberville1 ,mrs4 ,britt1 ,mrs4 ,capito1 ,mrs4 ,hyde-,smith1 and ,mr4 ,marshall7 introduced the following bill2 which was read twice and referred to the ,committee on ,finance ,a ,,bill ,to amend titles ,,xviii and ,,xix of the ,social ,security ,act to make improvements relating to the designation of rural emergency hospitals4 #a4 ,short title ,this ,act may be cited as the ,rural ,emergency ,hospital ,designation ,improvement ,act4 #b4 ,eligibility changes 7a7 ,in general ,section #ahfa7kkk77#c7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciex7kkk77#c77 is amended in the matter preceding subparagraph 7,a71 by striking as of and inserting at any point during the period beginning on ,january #a1 #bjae1 and ending on4 7b7 ,waiver of certain requirements ,section #ahfa7kkk77#c7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciex7kkk77#c771 as amended by subsection 7a71 is amended-- 7#a7 by redesignating subparagraphs 7,a7 and 7,b7 as clauses 7i7 and 7ii71 respectively2 7#b7 by striking described4--,a facility and inserting 8described4-- 7,a7 ,in general ,subject to subparagraph 7,b71 a facility 2 and 7#c7 by adding at the end the following new subparagraph3 7,b7 ,waiver ,not later than #a year after the date of enactment of this subparagraph1 the ,secretary shall promulgate regulations to waive the requirements under subparagraph 7,a7 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 subsection4 4 #c4 ,distinct part units ,section #ahfa7kkk77#f7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciex7kkk77#f77 is amended-- 7#a7 in subparagraph 7,a71 by striking and at the end2 7#b7 in subparagraph 7,b71 by striking the period at the end and inserting a semicolon2 and 7#c7 by adding at the end the following new subparagraphs3 7,c7 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 care2 7,d7 maintain or include a unit of the facility that is a distinct part licensed as an inpatient rehabilitation facility and allows for inpatient care2 and 7,e7 maintain or include a unit of the facility that is a distinct part licensed as an obstetric wing1 labor and delivery unit1 or obstetric emergency department4 4 #d4 ,add-on payment for diagnostic laboratory tests ,section #ahcd7x77#a7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciem7x77#a77 is amended-- 7#a7 by striking hospitals4-- and all that follows through ,in the case and inserting 8hospitals4-- 7#a7 ,in general 7,a7 ,payment for rural emergency hospital services ,in the case 2 and 7#b7 by adding at the end the following new subparagraph3 7,b7 ,payment for diagnostic laboratory tests ,in the case of clinical diagnostic laboratory tests and other diagnostic laboratory tests that are not covered ,,opd services 7as defined in section #ahcc7t77#a77;,b77 furnished by a rural emergency hospital 7as defined in section #ahfa7kkk77#b77 on or after ,january #a1 #bjbg1 the amount of payment for such tests shall be equal to the amount of payment that would otherwise apply under the applicable fee schedule1 increased by #e percent to reflect the higher costs incurred by such hospitals1 and shall include the application of any copayment amount determined under this part as if such increase had not occurred 4 #e4 ,swing beds ,section #ahfa7kkk77#f7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciex7kkk77#f771 as amended by section #c1 is amended-- 7#a7 in subparagraph 7,d71 by striking and at the end2 7#b7 in subparagraph 7,e71 by striking the period at the end and inserting 2 and2 and 7#c7 by adding at the end the following new subparagraph3 7,f7 may enter into an agreement with the ,secretary under which its facilities may be used for the furnishing of services of the type which1 if furnished by a skilled nursing facility would constitute extended care services4 ,payment to a rural emergency hospital for services furnished under such an agreement shall be based upon the reasonable cost of the services as determined under section #ahhc7;a77#b77;,b7 7if such section were applied by submitting rural emergency hospital for hospital and inpatient hospital in clauses 7ii7 and 7iii71 respectively1 of such section74 4 #f4 ,necessary provider status for facilities that revert to critical access hospital designation ,not later than #a year after the date of the enactment of this ,act1 the ,secretary of ,health and ,human ,services shall promulgate regulations to permit a rural emergency hospital 7as defined in section #ahfa7kkk77#b7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciex7kkk77#b777 that reverts back to its previous designation as a critical access hospital 7as defined in section #ahfa7mm77#a7 of such ,act 7#db ,u4,s4,c4 #aciex7m77#a777 to regain its status as a necessary provider of health care services pursuant to section #ahbj7;c77#b77;,b77i77,,ii7 of such ,act 7#db ,u4,s4,c4 #acie;i-#d7;c77#b77;,b77i77,,ii771 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 hospital4 #g4 ,national ,health ,service ,corps ,site ,eligibility ,the ,secretary of ,health and ,human ,services1 acting through the ,administrator of the ,health ,resources and ,services ,administration1 shall promulgate regulations to deem a rural emergency hospital 7as defined in section #ahfa7kkk77#b7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciex7kkk77#b777 to be a health professional shortage area in accordance with section #ccb7;a77#a77;,c7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bed;e7a77#a77;,c774 #h4 ,small rural hospital improvement program grants ,section #ahbj7;g7 of the ,social ,security ,act 7#db ,u4,s4,c4 #db ,u4,s4,c4 #acie;i-#d7;g77 is amended-- 7#a7 in paragraph 7#a77;,d71 by inserting or rural emergency hospitals 7as defined in section #ahfa7kkk77#b77 after critical access hospitals2 and 7#b7 in paragraph 7#c77;,a71 by inserting or rural emergency hospitals 7as defined in section #ahfa7kkk77#b77 after small rural hospitals4 #i4 ,inclusion of rural emergency hospital services under ,medicaid 7a7 ,in general ,section #aije7;a7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acif;d7a77 is amended-- 7#a7 in paragraph 7#b77;,a71 by inserting 7including rural emergency hospital services1 as defined in section #ahfa7kkk77#a71 which are licensed or otherwise approved by the ,state7 after services2 and 7#b7 in paragraph 7#d77;,a71 by inserting but including services provided in a nursing facility that is a distinct part unit of a rural emergency hospital1 as defined in section #ahfa7kkk77#b7 after diseases4 7b7 ,effective date 7#a7 ,in general ,subject to paragraph 7#b71 the amendments made by this subsection shall apply with respect to medical assistance provided on or after the date of enactment of this ,act4 7#b7 ,exception for state legislation ,in the case of a ,state plan under title ,,xix of the ,social ,security ,act 7#db ,u4,s4,c4 #acif et seq47 that the ,secretary of ,health and ,human ,services determines requires ,state legislation in order for such plan to meet any requirement imposed by the amendments made by this section1 such plan shall not be regarded as failing to comply with the requirements of such title solely on the basis of its failure to meet such an additional requirement before the first day of the first calendar quarter beginning after the close of the first regular session of the ,state legislature that begins after the date of the enactment of this ,act4 ,for purposes of the previous sentence1 in the case of a ,state that has a #b-year legislative session1 each year of the session shall be considered to be a separate regular session of the ,state legislature4