CMS' proposed rule for Rural Emergency Hospital designations: 8 things to know

CMS on June 30 issued proposed conditions of participation for hospitals looking to receive the rural emergency hospital designation. 

Eight things to know:

1. Rural emergency hospitals are a new Medicare provider designation that will create an opportunity for small rural hospitals and critical access hospitals to "right-size their service footprint" and avoid potential closures, according to CMS. 

2. CMS said allowing providers to take advantage of the designation will ensure people in rural communities will be able to receive critical outpatient services, including emergency, maternal health, behavioral health and substance use disorder services.

3. Conditions of participation will mostly align with current conditions for critical access hospitals. 

4. CMS is seeking input from the rural community on standards, such as the ability of a rural emergency hospital to provide low-risk childbirth-related labor and delivery services and whether CMS should require these hospitals also provide outpatient surgical services in the event surgical labor and delivery intervention become necessary.

5. CMS is also requesting comments regarding whether it is appropriate for an emergency rural hospital to allow a doctor of medicine or osteopathy, a physician assistant, a nurse practitioner or a clinical nurse specialist — with training or experience in emergency medicine — to be on call and immediately available by phone or radio contact and available on site within specified timeframes.

6. Rural emergency hospitals will be eligible to receive payment for services provided on or after Jan. 1. Payment rates were not outlined in the proposal. 

7. The final rule is expected to be included in the Calendar Year 2023 Outpatient Prospective Payment System-Ambulatory Surgical Center, which is set to be issued in the fall.  

8. Since 2010, 138 rural hospitals have closed, including a record 19 in 2020. 

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