Rural Emergency Hospital Designation Improvement Act
Sponsored By: Senator Moran, Jerry [R-KS]
Introduced
Summary
This bill would expand and strengthen rural emergency hospitals (REHs) so more rural facilities can convert, offer a wider range of inpatient services, and access targeted federal payments and program support. It focuses on loosening eligibility rules, adding payment boosts for some lab tests, creating a swing bed option for extended care, and folding REHs into Medicaid and other rural health programs.
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Bill Overview
Analyzed Economic Effects
4 provisions identified: 4 benefits, 0 costs, 0 mixed.
Easier rural hospital conversions and units
If enacted, rural emergency hospitals could include licensed inpatient psychiatric, inpatient rehabilitation, and obstetric units as distinct parts of the hospital. The bill would let a facility show it met REH eligibility at any time from January 1, 2015 through the applicable date. The Secretary would have one year to issue waiver regulations so similar facilities can convert to REHs. The Secretary would also have one year to issue rules letting some facilities that revert to critical access hospitals regain prior necessary‑provider status if they had it before converting.
Higher Medicare payments and local care
If enacted, rural emergency hospitals could enter agreements with HHS to provide 'swing bed' extended care like a skilled nursing facility. Medicare would pay those swing‑bed services on a reasonable‑cost basis using the statute's cost rules with specified substitutions. Also, qualifying diagnostic laboratory tests furnished by REHs on or after January 1, 2027 would be paid 5% above the applicable fee schedule. Any beneficiary copayment for those tests would still be calculated as if the 5% add‑on did not exist.
Medicaid coverage for rural emergency hospitals
If enacted, Medicaid would treat services that are licensed or approved as rural emergency hospital services as covered medical assistance. That would include services provided in a nursing facility that is a distinct part of an REH. Coverage would apply to medical assistance provided on or after enactment. States that need a law change would not be treated as noncompliant until the first day of the first calendar quarter after the close of their next regular legislative session (two‑year sessions count year‑by‑year).
More clinicians and grants for rural hospitals
If enacted, HHS (through HRSA) would issue rules to treat rural emergency hospitals as shortage‑area sites for the National Health Service Corps. That would let REHs qualify for NHSC clinician placements and recruitment programs. The bill would also make REHs eligible to apply for Small Rural Hospital Improvement Program grants. The bill does not itself appropriate new money for these programs.
Sponsors & CoSponsors
Sponsor
Moran, Jerry [R-KS]
KS • R
Cosponsors
Sen. Smith, Tina [D-MN]
MN • D
Sponsored 7/29/2026
Sen. Tuberville, Tommy [R-AL]
AL • R
Sponsored 7/29/2026
Sen. Britt, Katie Boyd [R-AL]
AL • R
Sponsored 7/29/2026
Sen. Capito, Shelley Moore [R-WV]
WV • R
Sponsored 7/29/2026
Sen. Hyde-Smith, Cindy [R-MS]
MS • R
Sponsored 7/29/2026
Sen. Marshall, Roger [R-KS]
KS • R
Sponsored 7/29/2026
Roll Call Votes
No roll call votes available for this bill.
View on Congress.gov