POLK COUNTY, IOWA – Sen. Chuck Grassley (R-Iowa) applauded the Centers for Medicare & Medicaid Services (CMS) for finalizing regulations for the new rural emergency hospital (REH) designation, a voluntary Medicare payment for rural hospitals that ensures minimal administrative burden, maximum flexibility and timely implementation while maintaining safe and high-quality care for patients. CMS is implementing a Grassley law passed in December 2020 and required to be implemented by January 1, 2023. It is intended to help rural hospitals keep their doors open, even if they cannot afford a fully operational inpatient unit.
 
“I appreciate the Centers for Medicare and Medicaid Services’ timely implementation of the voluntary rural emergency hospital (REH) program. REH offers a lifeline to maintain health care services in rural communities across Iowa and the country. When I first brought stakeholders and colleagues together in 2015, we envisioned a law that would give rural hospitals the option to right-size their health care infrastructure while maintaining essential medical services for their communities, such as emergency and outpatient services. Without REH, more hospitals would close and reduce access to critical care for so many Iowans, like expecting mothers and rural Iowans experiencing life-threatening emergencies.
 
“As then-chairman of the Finance Committee in 2020, I was glad to work on creating REH, and I’ve followed it closely ever since to ensure the program was implemented – right up to CMS issuing final regulations today. I look forward to reviewing the final regulations and will keep a close eye on the administrative efforts the agency will take to further implement the law.
 
“The existence of a rural hospital contributes to economic growth and can sustain a community. I believe CMS must continue to implement REH with minimal administrative burden and maximum flexibility for rural hospitals, while maintaining safe and high-quality care for patients. I will continue to work with stakeholders and CMS to ensure the law works for rural hospitals and communities as Congress intended,” Grassley said.

“MercyOne is proud to serve many of Iowa's communities. Iowans rely on our hospital and clinics for routine and life-saving medical care. The new Rural Emergency Hospital program is a key option to help sustain rural hospitals and access to care for many Iowans. We look forward to continued review of the final REH regulations, and we appreciate Sen. Grassley's leadership and the federal government taking action to support the Rural Emergency Hospital program,” said Bob Ritz, MercyOne CEO and President.

“UnityPoint Health appreciates Senator Grassley’s leadership in implementing the Rural Emergency Hospitals legislation. Now these agency regulations will support Iowans in rural communities by helping ensure they may continue to have access to timely emergency services in the future,” said Sue Erickson, SVP Chief Operating Officer for UnityPoint Health. 

“The IHA and member hospitals look forward to reviewing the final rules from CMS on the Rural Emergency Hospital (REH) designation and are pleased to see the program progress to the next step. The REH designation will help ensure access to critical health care services remain available wherever the patient is located, and hospitals will have what they need to take care of their communities,” said Iowa Hospital Association (IHA) President and CEO Chris Mitchell.
 
“The AHA is glad that CMS has finalized several proposals related to the Rural Emergency Hospital (REH) model. The REH model will help rural hospitals continue to serve as an access point to care in their communities, which is especially critical given the continued challenges they face in the current financial environment. We look forward to further engaging with the agency and Congress to refine the new provider type,” said Stacey Hughes, Executive Vice President for the American Hospital Association (AHA). 

In 2020, Grassley was instrumental in getting the REH designation signed into law. REH offers a financial lifeline for providers by allowing certain rural hospitals to customize their health care infrastructure and provide services that better align with the specific needs of their patient populations. The policy creates a new, voluntary Medicare payment designation that allows either a Critical Access Hospital (CAH) or a small, rural hospital with less than 50 beds to convert to an REH. The goal is to preserve patient access to emergency medical care in rural areas that can no longer support a fully operational inpatient hospital.
 
Grassley has consistently pressed the Biden administration on timely implementation of the REH – including in a recent letter containing several recommendations for CMS to consider based on concerns Grassley heard directly from Iowans. Grassley also pushed the issue during hearings with U.S. Department of Health and Human Services (HHS) Secretary Becerra, CMS Administrator Brooks-LaSure and HHS Deputy Secretary Palm. In 2021, Grassley wrote to CMS about prioritizing REH implementation.
 
As a lifelong resident of rural Iowa, Grassley understands the importance of having accessible health care services close to home and has fought to ensure rural America has access to health care. This work builds on his successful efforts to support the critical access hospital program, reauthorize the Medicare-dependent hospital program, establish and reauthorize the low volume hospital program and establish and reauthorize the rural community hospital demonstration, to name a few.
 

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