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Utah's Rural Hospital Flexibility Grant Program
The Utah Department of Health's Office of Primary Care and Rural Health is directing the activities of the Medicare Rural Hospital Flexibility (FLEX) Grant Program. The FLEX Program is authorized by Section 4201 of the Balanced Budget Act of 1997 (Public Law 105-33) and its amendments, the Balanced Budget Refinement Act of 1999, the Benefits Improvement and Protection Act of 2000 (BIPA), and the Medicare Prescription Drug and Modernization Act of 2003. For general information on the Rural Hospital Flexibility Program activities, you can review the "Rural Hospital Flexibility Program Fact Sheet". The Office has received a grant to carry out the activities of the Program.
The purpose of the Program is to:
- assist rural hospitals to become designated as "critical access hospitals." Hospitals designated as CAHs are eligible for cost-based Medicare reimbursement for inpatient and outpatient services, i.e. they are exempt from the Prospective Payment System (PPS). Criteria for participation in the program include the following:
- Hospitals may operate with up to a maximum of 25 acute care or swing beds.
- The average length of stay for acute care patients in a CAH must not exceed 96 hours.
- The hospital may be located less than a 35 mile drive (or in mountainous areas, a 15 mile drive) from a hospital or another CAH, if it meets additional State criteria as a "necessary provider." The "necessary provider" waiver authority ends after January 1, 2006.
- foster network development. The FLEX Program gives rural communities and hospitals the opportunity to enter into agreements regarding patient referral and transfer, development and use of communications systems (including telehealth), emergency and non-emergency transportation among network members, credentialing and quality assurance.
- improve and integrate EMS services. The FLEX Program will help with the establishment or expansion of programs to improve and integrate emergency services in Utah's rural communities.
- improve quality of care. CAHs are required to have agreements for credentialing or quality assurance with at least one hospital that is a member of the network to which the CAH belongs, one peer review organization (PRO) or equivalent entity, or another qualified entity identified by the State.
The Office works closely with the FLEX/CAH Advisory Committee, a broad-based group representing the interests of Utah's rural communities.
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