HB 2993 — Relating to rural emergency hospital licensure

WESTHB2993 VIRGINIAS LEGISLATUREH&HR REGULARAM SESSION#1 ENROLLED2-21Zopp  7869 The Committee Substituteon forHealth Houseand BillHuman 2993Resources BYmoved DELEGATESUMMERSto ANULLYamend [Passedthe Marchbill 2,by 2023;striking out everything after the enacting clause and inserting in lieu thereof the following: ARTICLE 5B.

inHOSPITALS effectAND ninetySIMILAR daysINSTITUTIONS.§16-5B-14. from passage.] Enr CS for HB 2993 AN ACT to amend and reenact §16-5B-14 of the Code of West Virginia, 1931, as amended, relating to rural emergency hospital licensure;

definingThe terms;Critical Access Hospital Designation Rural Emergency Hospital Act.(a) Definitions – As used in this section:(1) "Critical Access Hospital" means a hospital that has been deemed eligible and received designation as a critical access hospital by the Centers for Medicare and Medicaid Services (CMS).(2) "Rural Emergency Hospital" means a facility that:(A) Was a critical access hospital;(B) Does not provide acute care inpatient services;

settingand(C) forthProvides, licensureat standards;a minimum, rural emergency hospital services.(3) "Rural Emergency Hospital Services" means emergency department services andobservation care furnished by a rural emergency hospital that does not exceed an annual per patient average of 24 hours in such rural emergency hospital.(4) "Staffed Emergency Department" means an emergency department of a rural emergency hospital that meets the following requirements:(A) The emergency department is staffed 24 hours a day, 7 days a week;

permittingand(B) aA licensed physician, advanced practice registered nurse, clinical nurse specialist, orphysician assistant is available to furnish rural emergency hospital toservices performin certainthe functions;facility 24 hours a day.(b) A hospital located in an urban area (Metropolitan Statistical Areas (MSA) county), can be considered rural for the purposes of a designation as a critical access hospital pursuant to U.S.C.

§1395i-4(c)(2) if it meets the following criteria:(1) Is enrolled as both a Medicaid and providingMedicare rulemakingprovider authority.and accepts assignment for allMedicaid and Medicare patients;(2) Provides emergency health care services to indigent patients;(3) Maintains 24-hour emergency services;

Beand(4) itIs enactedlocated byin thea Legislaturecounty that has a rural population of West50 Virginia:percent or greater as determinedby the most recent United States decennial census.(b) (c) A critical access hospital designated pursuant to this section may apply to bedesignated licensed as a community outpatient medical center rural emergency hospital if:(1) It has been designated as a critical access hospital for at least one year;

ARTICLEand(2) 5B.It is designated as a critical access hospital at the time of application for licensure as a to convert to a community outpatient medical center rural emergency hospital.(c) (d) In addition to the requirements of subsection (b) (c) of this section, a community outpatient medical center rural emergency hospital shall, at a minimum:(1) Provide emergency medical care and observation care 24 hours a day, seven days aweek;

HOSPITALSrural ANDemergency SIMILARhospital INSTITUTIONS.services through a staffed emergency department;(2) Treat all patients regardless of insurance status;

§16-5B-14.and(3) Have protocols in place for the timely transfer of patients who require a higher level ofcare in effect a transfer agreement with a Level I or Level II trauma center.(e) A rural emergency hospital may:(1) With respect to services furnished on an outpatient basis, provide other medical andhealth services as specified by the secretary through rulemaking;

Ruraland(2) EmergencyInclude Hospitala Act.unit of a facility that is a distinct part licensed as a skilled nursing facility tofurnish post-hospital extended care services.(d) (f) The department of Health and Human Resources shall propose a new rule forlegislative approval in accordance with the provisions of §29A-3-1 et seq.

(a)of Definitionsthis –code Astoimplement usedthe inprovisions of this section:section. AdoptedRejected

(1) "Critical Access Hospital" means a hospitalthat has been deemed eligible and received designation as a critical access hospital by the Centers for Medicare and Medicaid Services (CMS).

(2) "Rural Emergency Hospital" means a facility that:

(A) Was a critical access hospital;

(B) Does not provide acute care inpatient services;

and (C) Provides, at a minimum, rural emergency hospital services.

(3) "Rural Emergency Hospital Services" means emergency department services and observation care furnished by a rural emergency hospital that does not exceed an annual per patient average of 24 hours in such rural emergency hospital.

(4) "Staffed Emergency Department" means an emergency department of a rural emergency hospital that meets the following requirements:

(A) The emergency department is staffed 24 hours a day, 7 days a week;

and (B) A licensed physician, advanced practice registered nurse, clinical nurse specialist, or physician assistant is available to furnish rural emergency hospital services in the facility 24 hours a day.

Enr CS for HB 2993 (b) A hospital located in an urban area (Metropolitan Statistical Areas (MSA) county), can be considered rural for the purposes of a designation as a critical access hospital pursuant to U.S.C.

§1395i-4(c)(2) if it meets the following criteria:

(1) Is enrolled as both a Medicaid and Medicare provider and accepts assignment for all Medicaid and Medicare patients;

(2) Provides emergency health care services to indigent patients;

(3) Maintains 24-hour emergency services;

and (4) Is located in a county that has a rural population of 50 percent or greater as determined by the most recent United States decennial census.

(c) A critical access hospital may apply to be licensed as a rural emergency hospital if:

(1) It has been designated as a critical access hospital for at least one year;

and (2) It is designated as a critical access hospital at the time of application for licensure as a rural emergency hospital.

(d) In addition to the requirements of subsection (c) of this section, rural emergency hospital shall, at a minimum:

(1) Provide rural emergency hospital services through a staffed emergency department;

(2) Treat all patients regardless of insurance status;

and (3) Have in effect a transfer agreement with a Level I or Level II trauma center.

(e) A rural emergency hospital may:

(1) With respect to services furnished on an outpatient basis, provide other medical and health services as specified by the secretary through rulemaking;

and (2) Include a unit of a facility that is a distinct part licensed as a skilled nursing facility to furnish post-hospital extended care services.

(f) The department shall propose a rule for legislative approval in accordance with the provisions of §29A-3-1 et seq.

of this code to implement the provisions of this section.

Enr CS for HB 2993 The Clerk of the House of Delegates and the Clerk of the Senate hereby certify that the foregoing bill is correctly enrolled.