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HHS/CMS RIN: 0938-AU92 Publication ID: Fall 2021 
Title: ●Requirements for Rural Emergency Hospitals (CMS-3419)(Section 610 Review) 

This proposed rule would establish health and safety requirements for a new provider type, Rural Emergency Hospitals, in accordance with section 125 of the Consolidated Appropriations Act, 2021.

Agency: Department of Health and Human Services(HHS)  Priority: Economically Significant 
RIN Status: First time published in the Unified Agenda Agenda Stage of Rulemaking: Proposed Rule Stage 
Major: Yes  Unfunded Mandates: Undetermined 
RFA Section 610 Review: Section 610 Review 
CFR Citation: Not Yet Determined     (To search for a specific CFR, visit the Code of Federal Regulations.)
Legal Authority: 42 U.S.C. 1395x   
Legal Deadline:
Action Source Description Date
Final  Statutory  Per statute, amendments made by this section apply to items and services furnished on or after January 1, 2023.  01/01/2023 

Statement of Need:

This rule proposes health and safety standards for Rural Emergency Hospitals (REHs).

Summary of the Legal Basis:

This rule addresses section 125 of the Consolidated Appropriations Act (Pub. L. No: 116-260), which establishes REHs as a new provider type eligible for Medicare payment.


We understand that the policies that will be included in this proposed rule will have impacts on rural communities and providers of health care services in these communities. These impacts will be taken into consideration as we evaluate policy alternatives in the development of this proposed rule. These alternatives will be included in the rule.

Anticipated Costs and Benefits:

This proposed rule aims to increase access to health care services, including emergency services, to rural communities. Many rural Americans face healthcare inequities resulting in worse outcomes overall in rural areas. Increasing access to key health care services in these communities will help address such healthcare inequities. Estimates of the cost and benefits of the developed provisions will be included in the proposed rule.


Although there are some risks associated with the potential loss of inpatient services in rural communities as providers convert to an REH, we anticipate that only eligible rural hospitals and critical access hospitals with very low average daily inpatient censuses will convert to an REH. We anticipate that the provisions of this proposed rule would help further HHS’s goal of increasing rural access to care.

Action Date FR Cite
NPRM  04/00/2022 
Regulatory Flexibility Analysis Required: Yes  Government Levels Affected: Federal, Local, State 
Small Entities Affected: Businesses, Governmental Jurisdictions, Organizations  Federalism: Undetermined 
Included in the Regulatory Plan: Yes 
RIN Data Printed in the FR: Yes 
Agency Contact:
Kianna Banks
Technical Advisor
Department of Health and Human Services
Centers for Medicare & Medicaid Services
Center for Clinical Standards and Quality, MS: S3-02-01, 7500 Security Boulevard,
Baltimore, MD 21244
Phone:410 786-8486