Senate GOP names new health Committee members

The Senate Republican Leadership announced the appointment of new members to Committees of Jurisdiction for health policy today.  Senators Dan Coats, Dean Heller and Tim Scott will join the Senate Finance Committee while Senators Susan Collins and Bill Cassidy will join the Health, Education, Labor and Pensions Committee. The new appointments are subject to the approval of the full Republican Conference.

These new appointments remind all of the importance of educating all Senators and Representatives on the needs of rural patients and providers.  NRHA’s annual Rural Health Policy Institute is the perfect opportunity to get involved and advocate for rural health. Registration information is available here.

CR-Omnibus Released

Late last night, the Appropriations Committee in the House of Representatives released their proposed text for a $1.1 trillion spending bill that would cover the rest of Federal fiscal year 2015.  The bill expands funding for NIH, CDC and Ebola-specific responses while modifying insurance risk corridors under the ACA and cutting funds for the Independent Payment Advisory Board.

The bipartisan measure does not address important NRHA priorities such as the SGR, Medicare “extenders” or the temporary Medicaid primary care payment increase. NRHA maintains that these programs must be extended and will make their permanency a major component of our ask at the Rural Health Policy Institute. Register today to join your voice to the chorus fighting for rural.

President Obama signed into law H.R. 4067

President Obama signed into law H.R. 4067, which will extend to all of calendar year 2014 the enforcement moratorium on the outpatient therapeutic services “direct supervision” policy for Critical Access Hospitals (CAHs) and rural prospective payment system hospitals with 100 or fewer beds.

H.R. 4067 was introduced by Senator Jerry Moran (R-KS) and Congresswoman Jenkins (R-KS) and passed both the House and Senate. The National Rural Hospital applauds the leadership of Sen. Moran and Rep. Jenkins for this important bill for CAHs and small rural hospitals.

Documentary “Remote Area Medical” to Screen in Washington with Special Appearance by NRHA CEO Alan Morgan

The National Rural Health Association invites you to the screening of the documentary Remote Area Medical. The film will screen at West End Cinema on December 5th at 7 p.m. and is the Washington premiere. Alan Morgan, NRHA CEO, will be a special guest and he will provide a lively discussion after the film.

Praised as “bittersweet…poignant. Those stories aren’t unlike a country ballad, and are arranged with a sensitivity to detail and the lives behind them, though not without interludes of rough humor by The Wall Street Journal, Jeff Reichert and Farihah Zaman’s documentary follows a three-day clinic held at the Bristol Motor Speedway in Tennessee and shows what it means when rural America does not have the access it needs to sufficient healthcare.

“This film is a glimpse into the lives of everyday rural Americans who struggle to access care,” Alan Morgan, CEO of the National Rural Health Association said. “Rural Americans, on average, are poorer, sicker and older than their urban counterparts. Remote Area Medical is a compelling story of those desperate for medical care.”

Filmmaker Jeff Reichert will also be appearing for a Q&A. The film won the Founders Prize for Best Documentary at the 2013 Traverse City Film Festival.

Film screening and discussion of Remote Area Medical will be held at the West End Cinema in Washington, DC at 7 p.m. on December 5. The film is open to the public; for tickets visit To view the trailer, visit:

CMS posts final/proposed rules

Today the Centers for Medicare and Medicaid Services (CMS) released a final rule outlining the hospital-specific limitation on Medicaid disproportionate share hospital payments under the Social Security Act. CMS claims that the final rule was written to provide ample flexibility to states and hospitals moving forward.  The final rule makes some modifications to the interim rule that has been in place since 2008.

CMS also released a proposed update to the Medicare Shared Savings Program–the program under which Medicare Accountable Care Organizations operate. The proposed rule is meant to “make refinements” to the program based on the experiences of various ACOs since the promulgation of the original rules in 2011.  NRHA will review the proposed update and provide comments.  CMS has stated that the comment period will be 60 days.

NRHA announces new and future leaders

Leadership for the National Rural Health Association is secure for 2015 and beyond, thanks to recent elections for its Board of Trustees positions and selection of candidates for its Rural Health Fellows program.

NRHA members elected Lisa Kilawee as president-elect. She will assume the duties of NRHA president in 2016, and Jodi Schmidt will serve as president in 2015.

Dave Pearson was elected to serve as NRHA’s board treasurer in 2015 and 2016.

NRHA is pleased to announce all individuals elected by their peers to serve in leadership roles.

NRHA is also proud to announce its ninth class of Rural Health Fellows.

After a competitive review process, 16 fellows were selected to participate in this yearlong, intensive program aimed at developing leaders who can articulate a clear and compelling vision for rural America.

“Once again, this class represents various levels of rural health expertise,” NRHA CEO Alan Morgan said. “With the successes achieved by the previous classes, we look forward to continuing the tradition of building rural health care leaders through this valuable program.”

Their first meeting will be during NRHA’s Rural Health Policy Institute Feb. 3-5 in Washington, D.C.

NRHA is thankful for rural victories

As Thanksgiving is around the corner, the National Rural Health Association is thankful for the many rural victories we have had to celebrate National Rural Health Day. National Rural Health Day has grown and is being recognized on Capitol Hill like never before.  Several significant speeches were given on both the House and Senate Floor.  Additionally, with the passage of the Senate Resolution and the direct supervision bill, this National Rural Health Day is our most successful to date.

Here are a few highlights of last Thursday:

S. Res. 588 (formerly S. Res. 26.) passes in the Senate.  On the evening of National Rural Health Day, Senators Moran (R-KS) and Klobuchar (D-MN) pushed to pass a resolution detailing the importance of rural hospitals and rural providers to patients and the rural economy.  Additionally, it outlines how important it is to provide fair reimbursement to those rural providers.  NRHA is thankful for Senators Moran and Klobuchar, as well as the other 17 original cosponsors.

Congress extends direct supervision enforcement moratorium. HR 4067, introduced by Congresswoman Jenkins (R-KS) passed both the House and Senate and now awaits the President’s signature.  It is anticipated that the President will sign.  The bill will extend to all of calendar year 2014 the enforcement moratorium on the outpatient therapeutic services “direct supervision” policy for critical access hospitals and rural prospective payment system hospitals with 100 or fewer beds.

NRHA and AHA send joint letter to Congress commemorating Rural Health Day. NRHA and the American Hospital Association teamed together to send a letter to the House Rural Health Coalition and the Senate Rural Health Caucus outlining the importance of Rural Health Day.  This event, we believe, exemplifies a new commitment on behalf of each association to work together toward to betterment of all rural hospitals.

NRHA is thankful for our rural champions and our NRHA members who support rural health care. But our work is not over yet. During December and the next year, NRHA will continue its efforts to protect the rural health safety net. NRHA asks you to continue the fight the 26th Annual Rural Health Policy Institute Feb. 3-5 in Washington, D.C. Click here to register today.

Senate passes rural health care resolution

Last night on National Rural Health Day, Senate Resolution 588 passed the Senate. The resolution, introduced by Senators Jerry Moran (R-KS) and Amy Klobuchar (D-MN), recognizes that access to hospitals and other health care providers for patients in rural areas of the United States is essential to the survival and success of communities in the United States.

Rural Americans face unique challenges in accessing health care. Per capita, they are sicker, older and frailer than their urban counterparts. The rural elderly are more likely to have chronic conditions such as arthritis, hypertension, diabetes and heart disease. They are also likely to be required to travel a greater distance when seeking care than urban counterparts.

The resolution states that “the closure of a hospital in a rural community often results in severe economic decline in the community and the departure of physicians, nurses, pharmacists, and other health providers from the community, and forces patients to travel long distances for care or to delay receiving care, leading to decreased health outcomes, higher costs, and added burden to patients.”

The National Rural Health Association applauds Sens. Moran and Klobuchar for recognizing the needs, challenges, and opportunities for rural health care facilities are also vastly different from those faced by their urban counterparts. Higher percentages of Medicare beneficiaries, recruitment challenges, workforce issues, and unique budgetary challenges are all examples of areas where rural facilities differ from their suburban and urban counterparts.

NRHA also thanks the 17 original cosponsors:

Senators Baldwin (D-WI); Boozman (R-AR); Cochran (R-MS); Crapo (R-ID); Donnelly (D-IN); Durbin (D-IL); Enzi (R-WY); Franken (D-MN); Grassley (R-IA); Heitkamp (D-ND); Heller (R-NV); Hirono (D-HI); Hoeven (R-ND);  Johnson (D-SD); Tester (D-MT); Thune (R-SD); and Wicker (R-MS).

NRHA and AHA send joint letter to Congress for National Rural Health Day

The National Rural Health Association and the American Hospital Association sent letters to the Senate Rural Health Caucus and the House Rural Healthcare Coalition in honor of National Rural Health Day yesterday.  The letters point to several legislative positives as well as continuing priorities for rural hospitals, including Medicare extenders and regulatory relief.  NRHA and AHA thank the chairs of both the Caucus and Coalition for their leadership and their ongoing commitment to rural America.

Sen. Grassley and Rep. Smith celebrate National Rural Health Day

The National Rural Health Association applauds Senator Chuck Grassley (R-Iowa) and Representative Adrian Smith (R-NE) for being stalwart champions for rural America.

Rep. Smith delivered a statement on the floor of the U.S. House of Representatives recognizing National Rural Health Day. The video of the remarks is here.

Sen. Grassley took the U.S. Senate floor today to deliver a statement on the importance of rural health care and to recognize rural health care providers:

“Approximately 62 million Americans live in rural areas, and they depend on an ever shrinking number of healthcare providers.  Rural providers play an important role in improving the health of their communities and supporting local economies.  I want to thank our rural providers—individuals, hospitals and clinics for all that they do.

Rural providers support a population that makes invaluable contributions to this country through food production, manufacturing and other vital industries.  Yet, more people in rural areas are living below the poverty line than their urban counterparts.  Rural hospitals are struggling to continue providing care due to declining payments, many exacerbated by the Affordable Care Act. The past few years have been marked by increasing rural hospital closures, with 27 hospitals shutting their doors in the last two years.  The trend is concerning and deserves attention as many more facilities and communities are at risk right now.

Once a hospital is gone, the devastating impact on the community cannot be undone.  The economic impact is unmistakable. The typical critical access hospital creates over 140 jobs in primary employment and $6.8 million in local wages while serving a population of over 14,000.”

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