MISSISSIPPI LEGISLATURE

1998 Regular Session

To: Public Health and Welfare; Appropriations

By: Representative Moody

AN ACT TO CODIFY SECTIONS 41-9-201 THROUGH 41-9-217, MISSISSIPPI CODE OF 1972, TO BE ENTITLED THE MISSISSIPPI RURAL HOSPITAL FLEXIBILITY ACT OF 1998; TO AUTHORIZE THE STATE DEPARTMENT OF HEALTH TO DEVELOP A STATE RURAL HEALTH CARE PLAN, IN ACCORDANCE WITH FEDERAL LAW, WHICH CREATES RURAL HEALTH NETWORKS IN THE STATE AND DESIGNATES RURAL NONPROFIT OR PUBLIC HOSPITALS OR FACILITIES AS CRITICAL ACCESS HOSPITALS; TO PROVIDE CERTAIN CRITERIA FOR DESIGNATION AS CRITICAL ACCESS HOSPITALS; TO AUTHORIZE THE STATE DEPARTMENT OF HEALTH TO PROMULGATE RULES AND REGULATIONS FOR THE ESTABLISHMENT OF RURAL HEALTH NETWORKS AND CRITICAL ACCESS HOSPITALS; TO PROVIDE INSURANCE AND OTHER COVERAGE TO PROVIDE BENEFITS FOR SERVICES PERFORMED BY CRITICAL ACCESS HOSPITALS; AND FOR RELATED PURPOSES. 

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MISSISSIPPI:

SECTION 1. The following provision shall be codified as Section 41-9-201, Mississippi Code of 1972:

41-9-201. Short Title.

This article is entitled and may be cited as the "Mississippi Rural Hospital Flexibility Act of 1998."

SECTION 2. The following provision shall be codified as Section 41-9-203, Mississippi Code of 1972:

41-9-203. State Policy.

It is the policy of the State of Mississippi to provide improved access to hospital and other health services for rural residents of the State of Mississippi and to promote regionalization of rural health services in Mississippi.

SECTION 3. The following provision shall be codified as Section 41-9-205, Mississippi Code of 1972:

41-9-205. Definitions.

When used in this article, the following definitions shall apply, unless the context indicates otherwise:

(a) "Act" means the Mississippi Rural Hospital Flexibility Act of 1998.

(b) "Critical access hospital" means a hospital which has been designated as a critical access hospital by the department in accordance with the Medicare Rural Hospital Flexibility Program, as provided for in Section 4201 of the Balanced Budget Act of 1997, Public Law 105-33, and which has entered into an agreement with at least one (1) full-service hospital to form a rural health network. The agreement or agreements must include provisions regarding patient referral and transfer, communications and patient transportation. A critical access hospital in a rural health network must also have an agreement for credentialing and quality assurance with at least one (1) hospital that is a member of the rural health network, or with a peer review organization or equivalent entity, or with another appropriate and qualified entity identified in the rural health care plan for the State of Mississippi.

(c) "Department" means the Mississippi State Department of Health.

(d) "Rural health network" means an organization consisting of at least one (1) critical access hospital and at least one (1) full-service hospital, the members of which have entered into certain agreements regarding patient referral and transfer, the development and use of communications systems and the provision of emergency and nonemergency transportation.

(e) "State rural health care plan" means Mississippi's rural health care plan that (i) provides for the creation of one or more rural health networks, consisting of at least one (1) critical access hospital and at least one (1) full-service hospital, (ii) promotes regionalization of rural health services in Mississippi, and (iii) improves access to hospitals and other health services for rural residents of Mississippi.

SECTION 4. The following provision shall be codified as Section 41-9-207, Mississippi Code of 1972:

41-9-207. State Rural Health Care Plan.

(1) The department is authorized, in accordance with the Medicare Rural Hospital Flexibility Program, as authorized by Section 4201 of the Balanced Budget Act of 1997, Public Law 105-33, to develop for the State of Mississippi a state rural health care plan that (a) provides for the creation of one or more rural health networks in Mississippi; (b) promotes regionalization of rural health services in Mississippi; and (c) improves access to hospitals and other health services for rural residents of Mississippi.

(2) The state rural health care plan shall be developed in consultation with the Mississippi Hospital Association and rural hospitals located in Mississippi.

(3) In developing the state rural health care plan, the department shall designate rural nonprofit or public hospitals or facilities located in Mississippi as critical access hospitals, which critical access hospitals must meet the criteria for such designation as set out in Section 4201 of the Balanced Budget Act of 1997.

SECTION 5. The following provision shall be codified as Section 41-9-209, Mississippi Code of 1972:

41-9-209. Designation as a Critical Access Hospital.

Any hospital is authorized to seek designation as a critical access hospital. There shall be no requirement or limitation regarding the distance that a critical access hospital must be located from another hospital. The bed-size limit for a critical access hospital is fifteen (15) operational beds, and the maximum length of stay for a patient in a critical access hospital is ninety-six (96) hours, unless a longer period is required because of inclement weather or other emergency conditions, or a peer review organization or other equivalent entity, on request, waives the ninety-six-hour restriction. An exception to the bed-size requirement is made for swing-bed facilities, which may have up to twenty-five (25) inpatient beds, provided that not more than fifteen (15) beds are used at any one time for acute care. A critical access hospital (a) must make available twenty-four-hour emergency care services, as described in the state rural health care plan, for ensuring access to emergency care services in the rural area served by the critical access hospital, and (b) must be a member of a rural health network.

SECTION 6. The following provision shall be codified as Section 41-9-211, Mississippi Code of 1972:

41-9-211. Formation of a Rural Health Network Not Subject to Antitrust Laws.

In forming an integrated network and in contracting for services, members of a rural health network and officers, agents, representatives, employees and directors of any member thereof shall be considered to be acting pursuant to clearly expressed state policy as established in this act under the supervision of the State of Mississippi and shall not be subject to state or federal antitrust laws while so acting.

SECTION 7. The following provision shall be codified as Section 41-9-213, Mississippi Code of 1972:

41-9-213. Rules and Regulations.

The department shall adopt, in accordance with Section 25-43-1 et seq., rules and regulations for the establishment and operation of rural health networks, including the designation of critical access hospitals of rural areas and minimum standards, as necessary, for those critical access hospitals.

SECTION 8. The following provision shall be codified as Section 41-9-215, Mississippi Code of 1972:

41-9-215. Insurance and Other Coverage to Provide Benefits for Services Performed by Critical Access Hospitals.

Each individual and group policy of accident and sickness insurance, each contract issued by health maintenance organizations, and all coverage maintained by an entity authorized under any article of Chapter 41, Title 83 of the Mississippi Code of 1972 shall provide benefits for services when performed by a critical access hospital if those services would be covered under such policies or contracts if performed by a full-service hospital.

SECTION 9. The following provision shall be codified as Section 41-9-217, Mississippi Code of 1972:

41-9-217. Additional Personnel.

The department is hereby authorized to hire additional personnel to implement this act pursuant to specific appropriations to the department for such purposes.

SECTION 10. Sections 1 through 9 of this act shall be inserted as a new article in Title 41, Chapter 9, Mississippi Code of 1972.

SECTION 11. This act shall take effect and be in force from and after its passage.