S. 5164 — Rural Emergency Hospital Designation Improvement Act

This section expands eligibility for conversion to rural emergency hospital status to facilities that operated as hospitals at any point from January 1, 2015, through the date of enactment. It directs the Secretary to issue regulations within one year waiving certain requirements for facilities that operate similarly to rural emergency hospitals.

This section requires certain facilities to maintain or include a distinct part unit licensed as an inpatient psychiatric unit for behavioral health patients, a distinct part unit licensed as an inpatient rehabilitation facility, and a distinct part unit licensed as an obstetric wing, labor and delivery unit, or obstetric emergency department.

This section increases Medicare payment by 5 percent for clinical diagnostic laboratory tests and other diagnostic laboratory tests that are not covered outpatient department services when furnished by a rural emergency hospital on or after January 1, 2027. Copayment amounts continue to be calculated as if the 5 percent increase had not applied.

This section authorizes rural emergency hospitals to enter into agreements with the Secretary to furnish extended care services through swing beds. Payments for these services are based on reasonable cost under the methodology in section 1883(a)(2)(B), with "rural emergency hospital" substituted for "hospital."

This section requires the Secretary of Health and Human Services to promulgate regulations within one year of enactment that permit a rural emergency hospital to regain necessary provider status upon reverting to critical access hospital designation, but only if the facility held necessary provider status before its prior conversion.

This section directs the Secretary of Health and Human Services to promulgate regulations deeming rural emergency hospitals to be health professional shortage areas.

This section expands eligibility for small rural hospital improvement program grants to rural emergency hospitals (as defined in section 1861(kkk)(2)), in addition to critical access hospitals under paragraph (1)(D) and small rural hospitals under paragraph (3)(A).

This section expands Medicaid coverage of medical assistance to include rural emergency hospital services, as defined in section 1861(kkk)(1) and licensed or approved by the state, as well as nursing facility services provided in a distinct part unit of such a hospital. The changes apply to services furnished on or after the date of enactment, or later for states requiring legislation.