From November 4, 2022 post

After pushing for this and other changes to benefit rural hospitals in our state, Senator James Lankford (R-OK) announced a huge win for rural hospital access in Oklahoma and around the nation. This week, the Centers for Medicare and Medicaid Services (CMS) announced its Rural Emergency Hospital (REH) rule, which among other things redefined a “primary” road for purposes of establishing the distance a hospital must be from another hospital to receive CMS’ Critical Access Hospital (CAH)—or now a Rural Emergency Hospital (REH) status.

“This is a huge win for access to rural health care in Oklahoma and around the nation. I’m glad CMS heard my calls, read my letters, and is paying attention to this issue and taking action to resolve it,” said Lankford. “Some rural-area Oklahomans are forced to drive hours to the nearest hospital, and when the future of those hospitals is threatened, they rightly get worried. We must ensure we don’t over generalize federal rules that can’t be tailored to certain areas. This rule change ensures our farmers and ranchers, oil and gas producers, and families who just want a quiet life in the country can still have access to quality health care and emergency services, no matter their zip code.”

This rule will help many Oklahoma rural hospitals remain open. Currently, a rural hospital has to be 35 miles away from another hospital via a “primary road” to be considered by CMS as a Critical Access Hospital (CAH), which is a designation that ensures the hospital can remain open in a rural or underserved area even if it is not a “busy” hospital. A CAH can be 15 miles away from another hospital via a “primary road” if it is in mountainous terrain. If a hospital is only accessible by a “secondary road,” it can be 15 miles away from the nearest hospital to be deemed a CAH.

This week’s rule change redefines “primary road,” which has meant basically any federal highway between hospitals. Now, a “primary road” must be a numbered federal highway “with two or more lanes each way, similar to the description of numbered state highways, and exclude numbered federal highways with only one lane in each direction.” As before, a CAH must be 35 miles away by primary road from another hospital, or 15 miles if in mountainous terrain.

In one instance where this definition has previously caused problems in Oklahoma, Harmon Memorial Hospital in Hollis, OK, became a CAH in 2016. However, due to an administrative error, CMS revoked Harmon’s CAH status. In October 2019, following outreach from the Oklahoma delegation, CMS gave the hospital two additional years to remain a CAH.

Lankford introduced the Rural Hospital Closure Relief Act, which supports financially vulnerable rural hospitals facing risk of closure. In June 2021, CMS determined that the Public Health Emergency (PHE) will not count toward Harmon’s two-year CAH extension, allowing Harmon to remain open as a CAH for almost 20 months after the PHE ends. However, if Harmon loses its CAH status before it can transition to an REH, it will close. In October 2021, Lankford, Inhofe, and Lucas introduced the Helping Account for Rural Medical Outpatient Needs in Oklahoma (HARMON) Oklahoma Act that would ensure Harmon Memorial Hospital, a rural hospital in Hollis, OK, can remain open as a CAH until it can transition to an REH. Nine hospitals have closed in Oklahoma between 2005 and 2020—the HARMON Oklahoma Act will help prevent another closure.

Lankford penned an op-ed in The Hill in 2020 to discuss the big need for access to hospitals in rural parts of our nation and the critical need our CAHs serve.

Original source can be found here.