HR 5481 — Rural Hospital Closure Relief Act of 2019

Summary

Rural Hospital Closure Relief Act of 2019 This bill allows additional hospitals to qualify as critical access hospitals (CAHs) that receive special payment under Medicare. Currently, in order to qualify as a CAH under Medicare, a hospital must either (1) be located more than 35 miles (or 15 miles in mountainous regions or areas with only secondary roads) from another hospital, or (2) have been certified prior to January 1, 2006, by the state as a necessary provider of services in the area. The bill allows a hospital to also qualify if the hospital is a small, rural hospital that (1) serves a health professional shortage area, or a high number of low-income individuals or Medicare or Medicaid beneficiaries; (2) has experienced financial losses for two consecutive years; and (3) attests to having a strategic plan to address financial solvency.

Bill Text

• Introduced Introduced in House Current html December 18, 2019

Compared against current U.S. Code AI-generated reading aid — verify against the official bill.

The bill amends the Social Security Act to restore state authority to waive the 35-mile rule for designating critical access hospitals under Medicare.

• 42 U.S.C. 1395i-4

  is certified on or after the date of the enactment of the Rural Hospital Closure Relief Act of 2019 by the State as being a necessary provider of health care services to residents in the area;

  States can now certify certain hospitals as necessary providers to waive the 35-mile rule.

• 42 U.S.C. 1395i-4

  For purposes of subparagraph (B)(i)(III), a hospital described in this subparagraph is a hospital that--

  Defines what constitutes a hospital eligible for the waiver.

• 42 U.S.C. 1395i-4

  is a sole community hospital (as defined in section 1886(d)(5)(D)(iii)), a medicare dependent, small rural hospital (as defined in section 1886(d)(5)(G)(iv)), a low-volume hospital that in 2019 receives a payment adjustment under section 1886(d)(12), or a subsection (d) hospital (as defined in section 1886(d)(1)(B)) that has fewer than 50 beds;

  Specifies the types of hospitals that can be considered under the new certification process.

• 42 U.S.C. 1395i-4

  is located in a rural area, as defined by the Secretary, based on the most recent rural urban commuting area code (or its successor criteria) as set forth by the Office of Management and Budget;

  Establishes rural location as a criterion for waiver eligibility.

• 42 U.S.C. 1395i-4

  as determined by the Secretary, serves a patient population--

  Identifies patient population service metrics as part of the eligibility criteria.

• 42 U.S.C. 1395i-4

  has demonstrated to the Secretary, at such time and in such manner as the Secretary determines appropriate, two consecutive years of financial losses preceding the date of certification described in subparagraph (B)(i)(III);

  Requires hospitals to show financial distress over two years to qualify for the waiver.

• 42 U.S.C. 1395i-4

  submit to the Secretary, at such time and in such manner as the Secretary may require, an attestation that the Secretary determines to be satisfactory, outlining the good governance qualifications and strategic plan for multi-year financial solvency of the hospital.

  Mandates a strategic plan for financial solvency from hospitals seeking certification.

• 42 U.S.C. 1395i-4

  In general.--The Secretary may not under subsection (e) certify pursuant to a certification by a State under subsection (c)(2)(B)(i)(III)--

  Establishes limits on the number of critical access hospitals that can be certified.

• 42 U.S.C. 1395i-4

  subject to clause (ii), within any one State, more than 15 facilities as critical access hospitals.

  Limits each state to a maximum of 15 new critical access hospital designations.

• 42 U.S.C. 1395i-4

  The Secretary may apply, with respect to a State, the limitation under clause (i)(II) by substituting a number that is greater than the number specified in such clause if the State petitions the Secretary, in accordance with a process established by the Secretary, to increase such number.

  Allows states to petition for an increase in the limit of certified hospitals.

• 42 U.S.C. 1395i-4

  , subject to subsection (c)(2)(G),

  Clarifies that the Secretary's authority to certify hospitals is subject to new limitations.

Action History

1. December 18, 2019

   Introduced in House

2. December 18, 2019

   Introduced in House

3. December 18, 2019

   Referred to the House Committee on Ways and Means.

Sponsors

• Adam Kinzinger · Primary
• David Loebsack · Cosponsor
• Jimmy Panetta · Cosponsor
• Rodney Davis · Cosponsor
• Cynthia Axne · Cosponsor
• Frank D. Lucas · Cosponsor
• Tom Cole · Cosponsor
• Fred Keller · Cosponsor
• Tim Walberg · Cosponsor
• Jack Bergman · Cosponsor
• Angie Craig · Cosponsor
• Michael Guest · Cosponsor
• John R. Moolenaar · Cosponsor
• Sanford D. Bishop · Cosponsor
• Bruce Westerman · Cosponsor
• Terri A. Sewell · Cosponsor
• Vicky Hartzler · Cosponsor
• Robert B. Aderholt · Cosponsor
• Troy Balderson · Cosponsor
• Cheri Bustos · Cosponsor
• Matt Cartwright · Cosponsor
• James Comer · Cosponsor
• Abby Finkenauer · Cosponsor
• TJ Cox · Cosponsor

Subjects