Rural Emergency Hospital RFI

August 4, 2021

The Centers for Medicare and Medicaid Services (CMS) released the Hospital Outpatient Prospective Payment System Proposed Rule for CY 2022 (CMS-1753-P) in the Federal Register Notice. Within the OPPS proposed rule there is a request for information (RFI) for the new provider type, the Rural Emergency Hospitals (REH).

  • Summarizes Sect 125 of Consolidated Appropriations Act of 2021, which creates REHs.  Statute specifies that REHs:
    • Are facilities that convert from either a Critical Access Hospital or a rural hospital with less than 50 beds and do not provide acute care inpatient services
    • Must furnish emergency department services and observation care and may provide other outpatient medical and health services as specified by the Secretary through rulemaking.
    • Medicare payment shall apply to items and services furnished on or after January 1, 2023.
  • Offers opportunity for stakeholders to comment on:
    • The extent to which the existing health and safety standards for hospitals, critical access hospitals (CAHs), and skilled nursing facilities (SNFs) should also apply to REHs;
    • Additional health and safety standards that should apply to REHs;
    • Quality measurement and reporting;
    • Payment policies;
    • Addressing health equity; and
    • Data sources, additional considerations, and unintended consequences that CMS should consider in the development of policies for REHs.

Comments are due September 17, 2021 on

For more information on REH the University of North Carolina Rural Health Research and Policy Center recently published a brief Estimating the Number of Hospitals that Might Convert to Rural Emergency Hospitals