Struck = removed from the bill ·
added = the amendment's new text.
StrickenHall languageof wouldthe beHouse deletedof fromRepresentatives and94th underlinedGeneral languageAssembly would- beRegular addedSession, to2023 presentAmendment law.Form ______________________________________________________________________ Subtitle of House Bill No.
Act1127 59TO ofCREATE theTHE RegularRURAL SessionEMERGENCY StateHOSPITAL ofACT; Arkansas As Engrossed:
H2/1/23AND 94thTO GeneralAUTHORIZE AssemblyLICENSURE AOF BillRURAL RegularEMERGENCY Session,HOSPITALS 2023BY HOUSETHE BILLDEPARTMENT 1127OF 5HEALTH. By:
Representative______________________________________________________________________ L.Amendment No.
Johnson1 By:to House Bill 1127 Amend House Bill No.
Senator1127 Irvinas 8originally Forintroduced: An Act To Be Entitled AN ACT TO CREATE THE RURAL EMERGENCY HOSPITAL ACT;
TOAdd AUTHORIZESenator LICENSUREIrvin OFas RURALa EMERGENCYcosponsor HOSPITALSof BYthe THEbill AND Page 1, delete line 10, and substitute "THE DEPARTMENT OF HEALTH;
AND FOR OTHER PURPOSES.PURPOSES." AND Delete the subtitle in its entirety and substitute:
Subtitle"TO TO CREATE THE RURAL EMERGENCY HOSPITAL ACT;
AND TO DECLARE AN EMERGENCY.EMERGENCY." AND Page 3, line 13, delete "1,000.00" and substitute "500.00" AND Page 5, delete line 12, and substitute the following:
BE"reimbursed. IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF ARKANSAS:
SECTION 1.
DO NOT CODIFY.
Title.
This act shall be known and may be cited as the "Rural Emergency Hospital Act".
SECTION 2.
DO NOT CODIFY.
Legislative findings and intent.
(a) The General Assembly finds that the importance and necessity of providing and regulating the system by which healthcare services are structured and integrated promotes the availability of and access to necessary and appropriate healthcare services to protect the general health, safety, and welfare of the rural residents of this state.
(b) It is the intent of the General Assembly to create a category of licensure to enable certain hospitals within this state to receive federal healthcare reimbursement as rural emergency hospitals in order to:
*JMB031* 02-01-2023 09:15:19 JMB031 As Engrossed:
H2/1/23 HB1127 (1) Improve the health of the rural population of this state;
(2) Preserve access to healthcare services and providers;
(3) Encourage collaboration among healthcare providers;
(4) Promote delivery of quality rural healthcare services and the efficiency and efficacy of rural healthcare services;
(5) Embrace technology in the delivery of rural healthcare services;
and (6) Promote adequate and fair reimbursement for rural healthcare services.
SECTION 3.
Arkansas Code § 20-9-201, concerning definitions relating to health facilities, is amended to add additional subdivisions to read as follows:
(13) “Rural emergency hospital” means an establishment that:
(A) Meets the eligibility requirements described in this subchapter;
(B) Provides rural emergency hospital services;
(C) Provides rural emergency services in the facility twenty-four (24) hours per day by maintaining an emergency department that is staffed twenty-four (24) hours per day and seven (7) days per week with a physician, nurse practitioner, clinical nurse specialist, or physician assistant;
(D) Has a transfer agreement in effect with a Level I or Level II trauma center;
and (E) Meets other requirements as the Department of Health finds necessary:
(i) In the interest of the health and safety of individuals who receive rural emergency hospital services;
and (ii) For implementation of a state licensure that satisfies requirements for reimbursement by federal healthcare programs as a rural emergency hospital;
and (14) “Rural emergency hospital services” means the following services provided by a rural emergency hospital that do not require more than twenty-four (24) hours on average in a rural emergency hospital:
(A) Emergency department services and observation care;
and 02-01-2023 09:15:19 JMB031 As Engrossed:
H2/1/23 HB1127 (B) At the election of the rural emergency hospital, other medical and health services provided on an outpatient basis as specified in regulations adopted by the United States Secretary of Health and Human Services and authorized by the Department of Health.
6 SECTION 4.
Arkansas Code § 20-9-214(b), concerning fees for the issuance of healthcare facility licenses, is amended to read as follows:
(b) The Department of Health may levy and collect the following annual fees for issuance of an annual license to hospitals or institutions:
Per facility FY '98 FY '99 (unless otherwise noted) (1) Hospitals (per bed) $ 4.00 $ 6.00 (2) Ambulatory Surgery Center 1,000.00 1,000.00 (3) Rural Emergency Hospital 500.00 (3)(4) Hospital-Based Recuperation Center 160.00 275.00 (4)(5) Freestanding Recuperation Center 2,000.00 2,000.00 (5)(6) Hospital-Based Alcohol/Drug Unit 60.00 75.00 (6)(7) Freestanding Alcohol/Drug Unit 1,000.00 1,000.00 (7)(8) Hospital-Based Outpatient Psychiatric Center 60.00 75.00 (8)(9) Freestanding Outpatient Psychiatric Center 1,000.00 1,000.00 (9)(10) Infirmary 100.00 100.00 (10)(11) Reissuance of license due to name/address change 100.00 100.00 SECTION 5.
Arkansas Code Title 20, Chapter 9, Subchapter 2, is amended to add an additional section to read as follows:
20-9-224.
Rural emergency hospitals.
(a) A healthcare facility shall be eligible to apply for a rural emergency hospital license if the healthcare facility on or before December 27, 2020, was a:
(1) Licensed critical access hospital;
(2) General hospital with not more than fifty (50) licensed beds located in a county in a rural area under 42 U.S.C.
§ 1395ww(d)(10)(C)(ii);
or (3) General hospital with not more than fifty (50) licensed beds that is deemed as being located in a rural area under 42 U.S.C.
§ 02-01-2023 09:15:19 JMB031 As Engrossed:
H2/1/23 HB1127 1395ww(d)(8)(E).
(b) A healthcare facility applying for licensure as a rural emergency hospital shall include with the licensure application:
(1) An action plan for initiating rural emergency hospital services, including a detailed transition plan that lists the specific services that the healthcare facility shall retain, modify, add, or discontinue, or any combination of retain, modify, add, or discontinue;
(2) A description of services that the healthcare facility intends to provide on an outpatient basis;
and (3) Other information as required by rules adopted by the Department of Health.
(c) A rural emergency hospital shall not have inpatient beds unless the rural emergency hospital has a unit that is a distinct part of the rural emergency hospital that (1) Is licensed as a skilled nursing facility to provide post- hospital extended care services;
or (2) Provides behavioral health services in accordance with the Arkansas Health and Opportunity for Me Act of 2021, § 23-61-1001 et seq.
(d) A rural emergency hospital may own and operate an entity that provides ambulance services.
(e)(1) A licensed general hospital or critical access hospital that applies for and receives licensure as a rural emergency hospital and elects to operate as a rural emergency hospital shall retain its original license as a general hospital or critical access hospital.
(2) The original license shall remain inactive while the rural emergency hospital license is in effect.
(f)(1) A rural emergency hospital, including a city, county, or other governmental or quasi-governmental hospital, may enter into any contracts required to be eligible for federal reimbursement as a rural emergency hospital.
(2)(A) An entity engaging in activities and entering into contracts required to meet the requirements for licensure and reimbursement as a rural emergency hospital and its officers, agents, representatives, employees, and directors are acting pursuant to clearly expressed state policy under the supervision of the state.
(B) An entity is not subject to state or federal antitrust 02-01-2023 09:15:19 JMB031 As Engrossed:
H2/1/23 HB1127 laws while acting in this manner.
(g) The State Board of Health shall adopt rules establishing the minimum standards for the establishment and operation of rural emergency hospitals in accordance with this section, including licensure of rural emergency hospitals.
(h)(1) A health benefit plan that is offered, issued, or renewed in this state shall provide benefits and coverage for services performed by a rural emergency hospital if the services would be covered under the health benefit plan if performed by a general hospital.
(2) As used in subdivision (h)(1) of this section, "health benefit plan" means the same as defined in § 23-79-1801.
(i) The Arkansas Medicaid Program shall reimburse a rural emergency hospital at the same or greater rate in which critical access hospitals are reimbursed.
and that this act is immediately necessary to keep rural *.JMB216* JMB216 - 01-31-2023 08:31:55 Page 1 of 2 hospitals in this state open and avoid the immediate risk of closure of rural hospitals that help preserve the health of the citizens of this state as well as to preserve the healthcare infrastructure in Arkansas.
or (3) If the bill is vetoed by the Governor and the veto is overridden, the date the last house overrides the veto.veto." The Amendment was read ________________________________________________________________________________ By:
/s/L.Representative L.
Johnson APPROVED:JMB/JMB - 01-31-2023 08:31:55 _________________________ JMB216 Chief Clerk JMB216 - 01-31-2023 08:31Amendment No.
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