(a) Definitions – As used in this section: (1) "Critical Access Hospital" means a hospital that has been deemed eligible and received designation as a critical access hospital by the Centers for Medicare and Medicaid Services (CMS). (2) "Rural Emergency Hospital" means a facility that: (A) Was a critical access hospital; (B) Does not provide acute care inpatient services; and (C) Provides, at a minimum, rural emergency hospital services. (3) "Rural Emergency Hospital Services" means emergency department services and observation care furnished by a rural emergency hospital that does not exceed an annual per patient average of 24 hours in such rural emergency hospital. (4) "Staffed Emergency Department" means an emergency department of a rural emergency hospital that meets the following requirements: (A) The emergency departmenet is staffed 24 hours a day, seven days a week; and (B) A licensed physician, advanced practice registered nurse, clinical nurse specialist, or physician assistant is available to furnish rural emergency hospital services in the facility 24 hours a day. (b) A hospital located in an urban area (Metropolitan Statistical Areas (MSA) county), can be considered rural for the purposes of a designation as a critical access hospital pursuant to U.SW.C. §1395i-4(c)(2) if it meets the following criteria: (1) Is enrolled as both a Medicaid and Medicare provider and accepts assignment for all Medicaid and Medicare patients; (2) Provides emergency health care services to indigent patients; (3) Maintains 24-hour emergency services; and (4) Is located in a county that has a rural population of 50 percent or greater as determined by the most recent United States decennial census. (c) A critical access hospital may apply to be licensed as a rural emergency hospital if: (1) It has been designated as a critical access hospital for at least one year; and (2) It is designated as a critical access hospital at the time of application for licensure as a rural emergency hospital. (d) In addition to the requirements of subsection (c) of this section, rural emergency hospital shall, at a minimum: (1) Provide rural emergency hospital services through a staffed emergency department; (2) Treat all patients regardless of insurance status; and (3) Have in effect a transfer agreement with a Level I or Level II trauma center. (e) A rural emergency hospital may: (1) With respect to services furnished on an outpatient basis, provide other medical and health services as specified by the Inspector General through rulemaking; and (2) Include a unit of a facility that is a distinct part licensed as a skilled nursing facility to furnish post-hospital extended care services. (f) The Inspector General shall propose a rule for legislative approval in accordance with the provisions of §29A-3-1 et seq. of this code to implement the provisions of this section.
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