S. 5164, Rural Hospital Reimbursement Expansion. Quorum's AI analysis reads it as a trade-off: gains for some, costs for others.
S. 5164 · Mixed
What it does
This bill expands eligibility and payment for rural emergency hospitals (REHs), a newer Medicare designation created to help small rural facilities stay open. It allows facilities that operated like REHs before 2015 to convert retroactively, permits REHs to add psychiatric, rehabilitation, and obstetric units, increases Medicare payment for diagnostic lab tests by 5%, allows REHs to operate swing beds (flexible inpatient/skilled nursing care), and extends various rural hospital support programs to include REHs. It also requires Medicaid to cover REH services.
The analysis names rural hospital operators and health systems — and 3 more groups — among the beneficiaries.
The trade-off
The 5% add-on payment for diagnostic lab tests (Section 4) applies automatically to all REHs without a cap or sunset, creating an open-ended federal cost increase that may grow as more facilities convert to REH status.
The analysis put a high warning level on this bill. Transparency scores 35%, and the analysis found no provisions unrelated to the bill's subject.
Who is behind it
Filed by Jerry Moran. Cosponsored by Cindy Hyde-Smith, Katie Britt, Roger Marshall and Shelley Capito.