Save Rural Communities Act of 2020
This bill establishes several requirements under Medicare regarding certified rural emergency access centers, including payment, certification, and participation requirements.
[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[H.R. 5808 Introduced in House (IH)]
<DOC>
116th CONGRESS
2d Session
H. R. 5808
To amend title XVIII of the Social Security Act to provide for coverage
of rural emergency medical access services under the Medicare program,
and for other purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
February 7, 2020
Mr. Arrington (for himself and Mr. Cuellar) introduced the following
bill; which was referred to the Committee on Ways and Means, and in
addition to the Committee on Energy and Commerce, 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
_______________________________________________________________________
A BILL
To amend title XVIII of the Social Security Act to provide for coverage
of rural emergency medical access services under the Medicare program,
and for other purposes.
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 ``Save Rural Communities Act of
2020''.
SEC. 2. MEDICARE RURAL EMERGENCY ACCESS CENTERS AND SERVICES.
(a) In General.--
(1) Rural emergency access center and services defined.--
Section 1861 of the Social Security Act (42 U.S.C. 1395x) is
amended--
(A) in subsection (e), in the last sentence of the
matter following paragraph (9), by inserting ``or a
rural emergency access center (as defined in subsection
(kkk)(1))'' before the period at the end; and
(B) by adding at the end the following subsection:
``Rural Emergency Access Center; Rural Access Medical Center Services
``(kkk)(1) The term `rural emergency access center' means a
facility that--
``(A) was, as of the date that is 2 years prior to the date
of the enactment of this subsection--
``(i) a hospital with not more than 50 beds located
in a county (or equivalent unit of local government) in
a rural area (as defined in section 1886(d)(2)(D));
``(ii) a hospital with not more than 50 beds that
was treated as being located in a rural area pursuant
to section 1886(d)(8)(E); or
``(iii) a critical access hospital;
``(B) provides 24-hour emergency medical care and
observation care that does not exceed an annual per patient
average of 24 hours or more than 1 midnight;
``(C) does not provide any acute care inpatient beds and
has protocols in place for the timely transfer of patients who
require acute care inpatient services or other inpatient
services;
``(D) provides for the transport of patients who require
acute care inpatient services or other inpatient services from
the rural emergency access center to a hospital or critical
access hospital, either by the rural emergency access center's
ambulance service provider or through another ambulance service
supplier;
``(E) has elected to be designated as a rural emergency
access center;
``(F) has been licensed by, or received approval to operate
as a qualified emergency medical center from, the State under
paragraph (3); and
``(G) is certified by the Secretary under paragraph (4).
``(2) The term `rural emergency access center services' means
medical and other health services furnished by a rural emergency access
center on an outpatient basis.
``(3) A facility may not operate as a rural emergency access center
unless the facility--
``(A) is located in a State that provides for the licensing
of emergency medical centers under State or applicable local
law; and
``(B)(i) is licensed pursuant to such law; or
``(ii) is approved by the agency of such State or locality
responsible for licensing hospitals, as meeting the standards
established for such licensing.
``(4) The Secretary shall certify a facility as a rural emergency
access center if the facility--
``(A) meets the criteria for rural emergency access center
described in subparagraphs (A) through (F) of paragraph (1);
``(B) has in effect a transfer agreement with a level I or
level II trauma center; and
``(C) meets such staff training and certification
requirements as the Secretary may require.''.
(2) Payment for rural emergency access center services.--
(A) In general.--Section 1833(a) of the Social
Security Act (42 U.S.C. 1395l(a)) is amended--
(i) in paragraph (8), by striking ``and''
at the end;
(ii) in paragraph (9), by striking the
period at the end and inserting ``; and''; and
(iii) by inserting after paragraph (9) the
following new paragraph:
``(10) in the case of rural emergency access center
services and services provided by a rural emergency access
center ambulance service provider or another ambulance service
supplier to transport patients who require acute care inpatient
services or other inpatient services from such rural emergency
access center to a hospital or critical access hospital, the
amounts described in section 1834(x).''.
(B) Payment amount.--Section 1834 of the Social
Security Act (42 U.S.C. 1395m) is amended by adding at
the end the following subsection:
``(x) Payment Rules Relating to Rural Emergency Access Centers.--
``(1) Payment for rural emergency access center outpatient
services.--The amount of payment for rural emergency access
center services of a rural emergency access center is
determined as follows:
``(A) Facility fee.--With respect to facility
services (other than services for which payment is made
under subparagraph (B)), the sum of the following:
``(i) OPPS rate.--The amount of payment
that would otherwise apply under section
1833(t) for covered OPD services (as defined in
section 1833(t)(1)(B) (other than clause (ii)
of such section)).
``(ii) Additional fee.--An additional
facility payment in an amount determined
appropriate by the Secretary that takes into
account the low volume of services provided by
such center and the low number of individuals
served by such center.
``(B) Professional services.--With respect to
professional services, the amount of payment that would
otherwise be made under this part (other than under
section 1833(t)(21)) for such services.
``(2) Payment for transportation services.--The payment
amount for ambulance services provided by a rural emergency
access center ambulance service provider or another ambulance
service supplier to transport patients who require acute care
inpatient services or other inpatient services from such rural
emergency access center to a hospital or critical access
hospital is equal to the sum of--
``(A) the amount that would otherwise be paid for
such ambulance services under section 1834(l); and
``(B) an additional amount determined appropriate
by the Secretary.''.
(b) Conditions of Participation.--Section 1866(a)(1) of the Social
Security Act (42 U.S.C. 1395cc(a)(1)) is amended--
(1) in subparagraph (X), by striking at the end ``and'';
(2) in subparagraph (Y), by striking at the end the period
and inserting ``, and''; and
(3) by inserting after subparagraph (Y) the following new
subparagraph:
``(Z) in the case of a rural emergency access center, to
meet requirements applicable to critical access hospitals under
this title, other than--
``(i) requirements relating to a Medicare rural
hospital flexibility program under section 1820(c),
including state designation of a facility as a critical
access hospital and criteria for such designation under
paragraph (2) of such section;
``(ii) requirements relating to critical access
hospitals and rural health networks under section
1820(d);
``(iii) certification by the Secretary as a
critical access hospital under section 1820(e);
``(iv) requirements relating to the provision of
inpatient hospital services or acute care beds by a
hospital or critical access hospital under this
section, including under--
``(I) paragraph (1)(G) of this subsection
(relating to certain payment restrictions for
inpatient hospital services); and
``(II) paragraph (1)(T) of this subsection
(relating to data submission requirements for
inpatient hospital services for purposes of the
low-volume adjustment); and
``(v) such others provisions of law or regulation,
including provisions under Part B and Part E, as the
Secretary may specify.''.
(c) Treatment as Telehealth Originating Site.--Section
1834(m)(4)(C)(ii) of the Social Security Act (42 U.S.C.
1395m(m)(4)(C)(ii)) is amended by adding at the end the following new
subclause:
``(XI) A rural emergency access
center (as defined in section
1861(kkk)(1)).''.
(d) Conforming Amendment.--Section 1861(u) of the Social Security
Act (42 U.S.C. 1395x(u)) is amended by inserting ``rural emergency
access center,'' after ``critical access hospital,''.
(e) 340B Covered Entity.--Section 340B(a)(4) of the Public Health
Service Act (42 U.S.C. 256b(a)(4)) is amended by adding at the end the
following new subparagraph:
``(P) A rural emergency access center (as defined
in section 1861(kkk)(1) of the Social Security Act) and
that meets the requirements of subparagraph (L)(i).''.
<all>
Introduced in House
Introduced in House
Referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, 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.
Referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, 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.
Referred to the Subcommittee on Health.
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