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.
[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[H.R. 5481 Introduced in House (IH)]
<DOC>
116th CONGRESS
1st Session
H. R. 5481
To amend title XVIII of the Social Security Act to restore State
authority to waive for certain facilities the 35-mile rule for
designating critical access hospitals under the Medicare program.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
December 18, 2019
Mr. Kinzinger (for himself, Mr. Loebsack, and Mr. Panetta) introduced
the following bill; which was referred to the Committee on Ways and
Means
_______________________________________________________________________
A BILL
To amend title XVIII of the Social Security Act to restore State
authority to waive for certain facilities the 35-mile rule for
designating critical access hospitals under the Medicare program.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Rural Hospital Closure Relief Act of
2019''.
SEC. 2. RESTORING STATE AUTHORITY TO WAIVE THE 35-MILE RULE FOR CERTAIN
MEDICARE CRITICAL ACCESS HOSPITAL DESIGNATIONS.
Section 1820 of the Social Security Act (42 U.S.C. 1395i-4) is
amended--
(1) in subsection (c)(2)--
(A) in subparagraph (B)(i)--
(i) in subclause (I), by striking at the
end ``or'';
(ii) in subclause (II), by inserting at the
end ``or''; and
(iii) by adding at the end the following
new subclause:
``(III) subject to subparagraph
(G), is a hospital described in
subparagraph (F) and 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;''; and
(B) by adding at the end the following new
subparagraphs:
``(F) Hospital described.--For purposes of
subparagraph (B)(i)(III), a hospital described in this
subparagraph is a hospital that--
``(i) 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;
``(ii) 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;
``(iii) as determined by the Secretary,
serves a patient population--
``(I) with a high percentage,
relative to the national or statewide
average, of individuals with income
that is below 150 percent of the
poverty line;
``(II) in a health professional
shortage area (as defined in section
332(a)(1)(A) of the Public Health
Service Act); or
``(III) that represents a high
proportion, relative to the national or
statewide average, of individuals
entitled to part A or enrolled under
part B of this title or enrolled under
a State plan under title XIX;
``(iv) 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); and
``(v) submits 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.
``(G) Limitation on certain designations.--
``(i) In general.--The Secretary may not
under subsection (e) certify pursuant to a
certification by a State under subsection
(c)(2)(B)(i)(III)--
``(I) more than a total of 200
facilities as critical access
hospitals; and
``(II) subject to clause (ii),
within any one State, more than 15
facilities as critical access
hospitals.
``(ii) State petition.--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.''; and
(2) in subsection (e), by inserting ``, subject to
subsection (c)(2)(G),'' after ``The Secretary shall''.
<all>
Introduced in House
Introduced in House
Referred to the House Committee on Ways and Means.
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