Rural Medical Assistance Facilities Act of 1989

Rural Medical Assistance Facilities Act of 1989 - Directs the Secretary of Health and Human Services to make ten to 15, four-year grants to no more than six States covering 90 percent of the costs of transforming a rural hospital into a medical assistance facility. Authorizes appropriations for such grant program.

Amends title XVIII (Medicare) of the Social Security Act to cover services provided by medical assistance facilities. Requires that such facilities: (1) be located in rural areas at least 30 miles from a hospital; (2) have less than 50 beds; (3) provide emergency care, stabilization care, and basic inpatient care for stays not exceeding four days; (4) provide ambulatory care in accordance with standards to be established by the Secretary; (5) receive quality assurance and utilization review services; (6) agree to participate in the Medicaid program (title XIX of the Act); and (7) have transfer and discharge planning agreements with referral hospitals. Authorizes such facilities to provide obstetric services and outpatient surgical care pursuant to protocols to be established by the Secretary.

Makes Medicare rural hospital staffing requirements applicable to medical assistance facilities, but authorizes facility care to be provided by nurse practitioners or physician assistance pursuant to protocols developed by the Secretary so that such facilities have flexibility in meeting physician "on-call" requirements. Exempts such facilities from hospital 24-hour service requirements.

Authorizes the Secretary to develop a methodology for reimbursing medical assistance facilities which differs from that used in reimbursing hospitals.

Amends the Medicaid program to cover services provided by medical assistance facilities.

Sets forth reporting requirements.