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) in subparagraph (D), by striking the period at the end and inserting a semicolon; and (C) by adding at the end the following new subparagraphs: (E) rural emergency hospitals providing support for critical access hospitals to convert to rural emergency hospitals to stabilize hospital emergency services in their communities; and (F) supporting certified rural health clinics for maintaining and building business operations, increasing financial indicators, addressing population health, transforming services, and providing linkages and services for behavioral health and substance use disorders responding to public health emergencies.; (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 FLEX 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 States and hospitals 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), by inserting State Offices of Rural Health on behalf of eligible hospitals and after award grants to; (B) by amending subparagraph (C) to read as follows: (C) Application The State Office of Rural Health shall submit an application, on behalf of eligible rural hospitals, to the Secretary on or before such date and in such form and manner as the Secretary specifies.; (C) by amending subparagraph (D), to read as follows: (D) Amount of grant A grant to a hospital under this paragraph shall be determined on an equal national distribution so that each hospital receives the same amount of support related to the funds appropriated.; (D) by amending subparagraph (E), to read as follows: (E) Use of funds State Offices of Rural Health and eligible hospitals may use the funds received through a grant under this paragraph for the purchase of computer software and hardware; the education and training of hospital staff on billing, operational, quality improvement and related value-focused efforts; and other delivery system reform programs determined appropriate by the Secretary.; and (5) 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 applicable rural health care provider, in partnership 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 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..