The following is a news release issued July 31, 2026 by the office of U.S. Sen. Jerry Moran (R-Kan.), originally headlined “Sens. Moran, Smith Introduce Bipartisan Legislation to Strengthen Rural Hospitals.” It is reprinted in full, unedited. View the original release.

REH 2.0 makes changes to bolster & improve the original REH Designation

WASHINGTON – U.S. Senators Jerry Moran (R-Kan.) and Tina Smith (D-Minn.) this week introduced the Rural Emergency Hospital Designation Improvement Act (REH 2.0), bipartisan legislation to expand access to federal resources for rural hospitals through the Rural Emergency Hospital (REH) Medicare designation. This legislation would allow more Critical Access Hospitals (CAH) and rural hospitals at risk of closure to sustain health care services in rural communities, and it would make technical improvements to the designation. The legislation is cosponsored by Sens. Tommy Tuberville (R-Ala.), Katie Britt (R-Ala.), Shelley Moore Capito (R-W.Va.), Cindy Hyde-Smith (R-Miss.) and Roger Marshall, M.D., (R-Kan.).

“I have visited every hospital in Kansas numerous times, and these conversations help guide my efforts to make certain health care providers across our state have the support they need to provide critical services to patients in their communities,” said Sen. Moran. “During these visits, providers shared with me their recommendations for strengthening the Rural Emergency Hospital designation so it can better support the struggling facilities it was originally intended to serve. The legislation I am introducing with Senator Tina Smith is the direct result of what we have heard from rural hospitals and health care providers in our states, and it makes needed improvements to the program to help make certain patients can continue to access critical health care services in their communities for years to come.”

“Rural hospitals are vital for families in small towns and rural communities. These hospitals not only provide care close to home, they’re also economic engines for their region,” said Sen. Smith. “But many rural hospitals face increasingly dire financial strain and workforce shortages, forcing them to cut services or even close down altogether. This important legislation is just one tool in the toolbox to help rural hospitals on the verge of closure keep their doors open. Make no mistake, much more is needed to ensure the health and wellness of rural hospitals and families.

“The Rural Emergency Hospital designation has already created new opportunities to preserve health care access in rural Kansas, but experience has also shown where additional flexibility is needed,” said Chad Austin, President and CEO of the Kansas Hospital Association. “The Rural Emergency Hospital Improvement Act represents the next step in strengthening this model by removing barriers that have prevented certain hospitals from participating and by providing commonsense improvements that will help more rural communities maintain access to essential services. We appreciate Senator Moran’s leadership and longstanding commitment to ensuring hospitals have the tools they need to care for their patients today and well into the future.”

“Healthcare access across rural Kansas is at a critical tipping point, with our state facing one of the highest numbers of at-risk rural hospitals in the nation,” said Tripp Owings, CEO of Ascension Via Christi. “The reality is that the needs of rural communities continue to evolve, and hospitals need the flexibility to adapt how they deliver care so they can preserve access and remain sustainable for the long term. When the Ascension Via Christi Emergency Department in Wellington opened in March 2021 to restore emergency services after the local hospital closed, we missed the initial federal REH cutoff by mere months, leaving our facility without a pathway to qualify. We thank Senator Moran for his continued support for rural hospitals in Kansas and we believe that REH 2.0 would provide important flexibilities to ensure more hospitals across Kansas and the country to adapt, stabilize, and maintain 24/7 emergency care close to home.”

“As the first Rural Emergency Hospital in Kansas, SCK Health has seen firsthand how the REH designation can preserve access to high-quality care in rural communities,” said Margaret Grismer, CEO of SCK Health. “The Rural Emergency Hospital Improvement Act builds on that success by providing the flexibility hospitals need to better serve their patients while strengthening the long-term sustainability of rural healthcare. We applaud Senator Moran’s leadership in advancing practical solutions that help ensure rural Kansans continue to receive the care they deserve, close to home.”

“In the fall of 2015, the hospital located in Independence, Kansas closed.  Labette Health located 35 miles east of Independence worked with local leaders, KDHE, the USDA, and Senator Moran to open an off-campus Emergency Room, Observation Unit, and Rural Health Clinic on July 4, 2017, in Independence. This REH 2.0 will provide two paths to sustainability for Independence Healthcare Center as either an REH or as a ‘REH like’ facility,” said Brian Williams, President and CEO of Labette Health. 

“REH 2.0 will provide needed updates to the Rural Emergency Hospital model by allowing those REH hospitals in America’s most rural and vulnerable areas to provide Swing Bed Skilled services for their communities, along with other vital legislative updates, such as Medicaid payment parity,” said Aaron Herbel, Administrator of Mercy Hospital. “Rural Emergency Hospitals across the U.S., including Mercy Hospital in Moundridge, Kansas, are grateful for the continued support that Senator Moran has showed by authoring this essential legislation.”

The REH Designation Improvement Act is also supported by the National Rural Health Association.

The provisions in the REH Designation Improvement Act are the result of numerous conversations Sen. Moran held with rural health care providers and CEOs of hospitals that are eligible for the REH designation. Originally created with the support of Sen. Moran as part of the Consolidated Appropriations Act of 2021, REH is a Medicare provider designation that offers certain rural hospitals the opportunity to convert and continue operating with limited services rather than closing.

The Rural Emergency Hospital Designation Improvement Act would:

• Allow previously closed rural hospitals to re-open and apply for the Rural Emergency Hospital designation if they can demonstrate they met all eligibility requirements between Jan. 1, 2015, and Dec. 27, 2020.
• Direct the Secretary of Health and Human Services (HHS) to create a waiver program for facilities operating similarly to an REH in order to convert to an REH.
• Allow REH facilities to maintain or create a unit for inpatient psychiatric care, obstetric care and allow for limited inpatient rehabilitation services.
• Require the Centers for Medicare & Medicaid Services to provide additional funding for laboratory services.
• Clarify that REH facilities are eligible for Small Rural Hospital Improvement grants.
• Direct the Secretary of HHS to allow an REH to be eligible as a National Health Service Corp site.
• Authorize REH facilities to transfer patients from acute care to a Skilled Nursing Facility without leaving the hospital, in accordance with the Social Security Act.
• Allow an REH facility to revert back to a Critical Access Hospital (CAH) to regain necessary provider status, only if the facility was designated a necessary provider prior to converting to REH.
• Clarify state Medicaid agencies can pay REH facilities as hospitals.

Full text of the legislation can be found HERE. 

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