The Rural ER Access Act eliminates the 35-mile distance requirement for off-campus facilities to qualify for Medicare provider-based status, expanding emergency care access in rural areas.
Mark Green
Representative
TN-7
The Rural ER Access Act aims to improve emergency healthcare in underserved areas by removing restrictive geographic limitations for Medicare-certified facilities. By eliminating the requirement that off-campus facilities be located within 35 miles of a main hospital, this legislation allows rural providers to expand their reach and maintain essential provider-based status.
Rural ER Access Act Ends 35-Mile Restriction: Medicare Rule Change Aims to Expand Countryside Care
The Rural ER Access Act targets a specific piece of red tape that has long kept medical facilities in the middle of nowhere from getting the financial support they need. Right now, Medicare rules generally require an off-campus clinic or emergency room to be within 35 miles of its 'parent' hospital to be considered part of that hospital for payment purposes. This bill directs the Secretary of Health and Human Services to scrap that 35-mile radius requirement entirely, and it gives the department just 60 days to get the paperwork updated once the bill is enacted.
Cutting the Geographic Cord
Under current regulations (specifically 42 CFR 413.65), if a hospital in a major city wants to open a specialized ER or clinic in a remote town 50 miles away, that new facility often struggles to qualify for 'provider-based status.' This status is a big deal because it dictates how Medicare reimburses the facility for services. By removing the 35-mile limit, the bill allows hospitals to extend their reach much further into rural territory without facing the financial penalty of being classified as a standalone, independent entity. For a resident in a remote county, this could mean the difference between a 15-minute drive to a modern, hospital-affiliated ER and a two-hour trek to the nearest major city.
The 60-Day Sprint to Rural Relief
The bill is notably direct about its timeline, forcing a regulatory change within a two-month window. This isn't just about moving lines on a map; it’s about the bottom line for rural healthcare infrastructure. For a nurse practitioner running a clinic in a town that lost its local hospital years ago, this change could allow a larger regional health system to officially adopt that clinic, bringing in better equipment and more stable funding. By focusing strictly on the 'location requirements' in Section 2, the legislation attempts to fix a logistical hurdle that has historically made it too expensive for big hospitals to help small towns.