[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[H.R. 10187 Introduced in House (IH)]
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118th CONGRESS
2d Session
H. R. 10187
To amend title XVIII of the Social Security Act to modify Medicare
rural hospital flexibility program grants.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
November 20, 2024
Mrs. Miller of West Virginia (for herself and Ms. Sewell) 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 modify Medicare
rural hospital flexibility program grants.
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 Flexibility Act of
2024''.
SEC. 2. MEDICARE RURAL HOSPITAL FLEXIBILITY PROGRAM GRANTS.
Section 1820(g) of the Social Security Act (42 U.S.C. 1395i-4(g))
is amended--
(1) in paragraph (1)--
(A) in subparagraph (C), by striking ``and'' at the
end;
(B) by amending subparagraph (D) to read as
follows:
``(D) providing support for critical access
hospitals, certified rural health clinics, and rural
emergency hospitals (as defined in section
1861(kkk)(2)) for quality improvement, quality
reporting, performance improvements, benchmarking,
addressing population health, transforming services,
and providing linkages and services for behavioral
health and substance use disorders responding to public
health emergencies; and''; and
(C) by adding at the end the following new
subparagraph:
``(E) providing support for critical access
hospitals to convert to rural emergency hospitals to
stabilize hospital emergency services in their
communities.'';
(2) by redesignating paragraphs (3) through (7) as
paragraphs (4) through (8), respectively;
(3) after paragraph (2), by inserting the following new
paragraph:
``(3) Activities to support carrying out other grants.--The
Secretary may award grants or cooperative agreements to
entities that submit to the Secretary applications, at such
time and in such form and manner and containing such
information as the Secretary specifies, for purposes of
supporting recipients in carrying out the activities under this
subsection by providing technical assistance, data analysis,
and evaluation efforts.'';
(4) in paragraph (4), as redesignated--
(A) in subparagraph (A)--
(i) in the header, by striking
``hospitals'' and inserting ``State offices of
rural health''; and
(ii) by striking ``grants to hospitals''
and inserting ``grants to State Offices of
Rural Health'';
(B) in subparagraph (B)--
(i) by redesignating clauses (i) and (ii)
as subclauses (I) and (II), respectively;
(ii) by striking ``means a non-Federal''
and inserting the following: ``means--
``(i) a non-Federal''; and
(iii) by striking the period at the end and
inserting the following: ``; or
``(ii) a rural emergency hospital (as
defined in section 1861(kkk)).'';
(C) by amending subparagraph (C) to read as
follows:
``(C) Application.--The State Office of Rural
Health shall submit an application to the Secretary on
or before such date and in such form and manner as the
Secretary specifies.'';
(D) by amending subparagraph (D), to read as
follows:
``(D) Amount of grant.--With respect to funds made
available to make grants under this paragraph in a
fiscal year, the amount awarded to a State Office of
Rural Health shall bear the same ratio to the total
amount of such funds so made available as the number of
eligible small rural hospitals such Office proposes to
assist with such grant bears to the total number of
eligible small rural hospitals all such Offices
receiving a grant under this paragraph for such fiscal
year propose to assist with such grants.'';
(E) by amending subparagraph (E), to read as
follows:
``(E) Use of funds.--State Offices of Rural Health
may use the funds received through a grant under this
paragraph for the purchase of computer software and
hardware on behalf of eligible small rural hospitals,
for the education and training of eligible small rural
hospital staff on billing, operational, quality
improvement, and related value-focused efforts, and for
other delivery system reform programs determined
appropriate by the Secretary.''; and
(F) in subparagraph (F)--
(i) in clause (i), by striking ``A hospital
receiving a grant under this section'' and
inserting ``An entity receiving a grant under
this paragraph''; and
(ii) in clause (ii), by striking
``section'' each place such term appears and
inserting ``paragraph'' in each such place;
(5) in paragraph (5), as redesignated, by striking
``paragraph (1) or (2)'' and inserting ``paragraph (1), (2), or
(4)''; and
(6) by adding at the end the following new paragraph:
``(9) Rural health transformation grants.--
``(A) Grants.--The Secretary may award 5-year
grants to State Offices of Rural Health and to eligible
rural health care providers (as defined in subparagraph
(D)) on the transition to new models, including rural
emergency hospitals, extended stay clinics,
freestanding emergency departments, rural health
clinics, and integration of behavioral, oral health
services, telehealth and other transformational models
relevant to rural providers as such providers evolve to
better meet community needs and the changing health
care environment.
``(B) Application.--An eligible rural health care
provider, in consultation with the State Office of
Rural Health in the State in which the rural health
care provider seeking a grant under this paragraph is
located, shall submit an application to the Secretary
on or before such date and in such form and manner as
the Secretary specifies.
``(C) Additional requirements.--The Secretary may
not award a grant under this paragraph to an eligible
rural health care provider unless--
``(i) local organizations or the State in
which the hospital is located provides support
(either direct or in kind); and there are
letters of support from key State payers such
as Medicaid and private insurance; and
``(ii) the applicant describes in detail
how the transition of the health care provider
or providers will better meet local needs and
be sustainable.
``(D) Eligible rural health care provider
defined.--For purposes of this paragraph, the term
`eligible rural health care provider' includes a
critical access hospital, a certified rural health
clinic, a rural nursing home, skilled nursing facility,
emergency care provider, or other entity identified by
the Secretary. An eligible rural health care provider
may include other entities applying on behalf of a
group of rural health care providers such as a State
Office of Rural Health, a State or local health care
authority, a rural health network, or other entity
identified by the Secretary.''.
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