HR-10293-119
Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Sponsored by Jill Tokuda (D-HI)
What it does
This bill would broaden which rural facilities can convert to "Rural Emergency Hospital" status by extending the eligibility lookback period and directing HHS to waive certain requirements for similarly-operating facilities. It would also let these hospitals add psychiatric, rehabilitation, and obstetric distinct-part units, add swing-bed skilled nursing services, add a 5% payment increase for diagnostic lab tests, restore "necessary provider" status for facilities that revert to critical access hospital status, deem these hospitals health professional shortage areas for National Health Service Corps placement purposes, make them eligible for Small Rural Hospital Improvement Program grants, and include their services under Medicaid.
Who benefits
Rural hospitals currently at risk of closure or already converted to Rural Emergency Hospital status, rural patients who would gain access to inpatient psychiatric, rehabilitation, and obstetric care and skilled nursing swing beds, rural communities facing maternity and behavioral health care shortages, National Health Service Corps clinicians seeking loan repayment placements, and hospital administrators seeking additional federal grant funding and Medicaid reimbursement.
Who is hurt
Federal and state Medicaid budgets and the Medicare program would bear increased costs from expanded services, higher lab test payments, and new grant eligibility. Competing rural and critical access hospitals not eligible for these designations could see reduced competitive advantage, and taxpayers would ultimately fund the added spending. State Medicaid agencies would face implementation and administrative burdens to incorporate the new service categories.
Supporters argue
Supporters argue that many rural hospitals converted to Rural Emergency Hospital status since 2015 but were locked out of full participation due to rigid eligibility dates, and that this bill lets more struggling facilities qualify while restoring services like obstetric and behavioral health care that rural areas desperately need. They contend that a 5% lab payment increase and Medicaid inclusion reflect the genuinely higher costs rural facilities face and would help stem the wave of rural hospital closures and maternity care deserts documented by rural health researchers.
Opponents argue
Opponents argue that expanding eligibility and adding new covered services and payment increases would raise Medicare and Medicaid spending without firm cost controls or offsets specified in the bill, shifting financial risk to federal and state budgets. They contend that delegating broad waiver authority to HHS to redefine which facilities qualify could result in inconsistent implementation across states and may extend federal payment advantages to facilities that do not meet the original policy rationale for the Rural Emergency Hospital designation.