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[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[H.R. 10187 Introduced in House (IH)]

<DOC>

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.''.
                                 <all>
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