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What should my group know about the CMS’ new rules?

Rural hospitals are struggling throughout the country. A recent piece in Becker’s Hospital Review notes that 138 rural hospitals have closed since 2010. Notably, a record 19 closed in 2020 alone.

To address this growing problem, the United States Centers for Medicare and Medicaid Services (CMS) recently announced a new designation: rural emergency hospital. The agency has stated it hopes this new designation will provide small rural hospitals with the aid they need to continue operations and reduce the risk of additional closures.

The agency recently released a list of proposed conditions for hospitals looking to receive this designation. The conditions are like those used for the critical access hospital designation. Facilities that currently operate with the critical access hospital designation can convert to a rural emergency hospital designation. The conversion can expand provision to include:

  • Emergency services
  • Observation care
  • Certain medical and health outpatient services

The CMS clarifies that release of the proposed rule is just the first step towards implementation of the new rural emergency hospital designation. It is also important to note that the particulars of the proposal could change. CMS has called on the rural community to provide input. They specifically point to whether the move benefits low-risk childbirth services and outpatient surgical services for labor and delivery intervention. We will provide updates on the progress of this proposal as they become available.

When will this go into effect?

If all goes well, the agency will include the rule in the 2023 Outpatient Prospective Payment System-Ambulatory Surgical Center, issued in the fall.

Is there anything else our group should know?

Towards the end of the announcement, the CMS also notes that it wants to update the conditions of participation for critical access hospitals. The agency is looking to add a definition of primary roads and update the distance requirements as well as put together a patient’s rights conditions of participation and integrate systems for infection control and prevention efforts.

Attorney John Rivas is responsible for this communication