NRHA calls for Congress to protect important rural programs

Millions of rural Americans, and rural Medicare beneficiaries, depend on their local hospitals to access primary, acute, and emergency care.

If the Medicare Dependent Hospital and Low-Volume Hospital programs expire, hundreds of rural communities will be exposed to a reduction of services in their local facility, job loss, or worse —closure of their local hospital.

Because they serve this uniquely vulnerable population, these rural hospitals operate on razor thin margins. Already 48 hospitals have closed since 2013 and right now 283 teeter on the brink of closure.  Without these vital Medicare rural health programs, rural hospitals are in even greater danger.

Expiration of other programs such as the rural work floor in the geographic practice cost index and rural ambulance payments will further hurt rural Americans’ access to health care. NRHA calls on Congress to act to avoid these dire outcomes by permanently extending the Medicare Dependent Hospital designation, Low-Volume Hospital adjustment, the current rural and “super-rural” ambulance payments, and the rural work floor in the Geographic Practice Cost Index (GPCI) now.

If these programs are allowed to expire, rural Medicare beneficiaries’ access to primary, emergency and hospital care is in serious jeopardy. Call your members of Congress today and tell them to protect these critical rural health programs.

NRHA applauds Ways and Means Committee for Medicare markup

The Ways and Means Committee favorably reported four Medicare bills in a markup held today. In his opening statement, Chairman Paul Ryan (R-Wis.) emphasized the bipartisan nature of the bills, saying  “when we have a chance to find common ground – to move our country forward – we shouldn’t shy away from that.”

The bills addressed Medicare fraud (H.R. 1021, Protecting the Integrity of Medicare Act of 2015), addressed certain issues with durable medical equipment bidding (H.R. 284, the Medicare DMEPOS Competitive Bidding Improvement Act of 2015), require patients be informed when they are held more than 24 hours on observation status (H.R. 876, the NOTICE Act), and exclude patient encounters in ambulatory surgical centers (ASC) from counting for meaningful use until EHRs are certified for use in an ASC (H.R. 887, the Electronic Health Fairness Act of 2015).

The National Rural Health Association is pleased to see the committee marking up important bipartisan legislation and continues to work with the Ways and Means Committee on issues of rural health.

Learn more about Medicare bills and other legislation impacting rural health at NRHA’s 38th Annual Rural Health Conference April 14-17 in Philadelphia.

Permanent LVH and MDH legislation introduced

The National Rural Health Association applauds the introduction of the bipartisan Rural Hospital Access Act (H.R. 663) introduced by Reps. Tom Reed and Peter Welch and its companion Senate bill S.332 introduced by Sens. Grassley and Schumer.

The bill will make permanent two crucial rural hospital payments, the Medicare-dependent hospital program and low-volume hospital adjustment.

These two programs are essential for many small rural providers operating on razor-thin margins and are an important part of ensuring rural facilities can remain open and able to see the many Medicaid and Medicare patients they serve.

These programs were created to ensure rural hospitals can continue to provide much needed services in their community. Since rural residents are more likely to be older, poorer and sicker than their urban counterparts, these programs were created to ensure Medicare payments better reflect the actual costs of providing care in rural areas.

Currently, NRHA along with rural hospitals and other advocates must appeal annually to Congress to ensure the programs continue each year. These important bills will provide hospitals, and the communities they serve, the ability to better plan for the future by making these important programs permanent.

NRHA encourages members of Congress to cosponsor these important bills and encourages Congress to act quickly to make these important programs permanent.Schumer and NRHA membersKeith Mueller, Carolyn Sheridan and Ed Friedmann, NRHA members from Iowa, presented Sen. Chuck Grassley with the National Rural Health Association’s 2015 Legislative Award on Feb. 5 for his outstanding efforts on behalf of rural patients and providers.

President’s FY 2016 calls for cuts to rural programs

President Obama’s budget proposal, released last week, continues to be a source of concern for many rural providers.

The White House’s FY 2016 budget calls for eliminating important rural health programs including the Area Health Education Centers (AHECs) and Rural Access to Emergency Devices.

President Obama again proposes cuts to Critical Access Hospitals (CAHs), including a cut in cost-based reimbursement and the elimination of the designated CAH status if another facility is within 10 miles, regardless of the care that the other facility offers.

Other programs facing cuts are the Health Information Technology Research, Rural Hospital Flexibility Grant, and the Preventive Health and Health Services Block Grant.

NRHA will continue its efforts to ensure that these cuts are not enacted. NRHA asks that members of Congress stand up for rural Americans and provide adequate funding to train and retain a quality workforce in rural America. NRHA’s funding requests for FY 2016 can be found here.

NRHA disappointed by Obama’s budget

The National Rural Health Association is disappointed with the president’s budget that again calls for cuts to critical access hospitals (CAH).

Obama’s 2016 budget proposal announced yesterday includes both a cut in cost-based reimbursement and the elimination of federally designated CAH status if another facility is less than 10 miles away.

“This budget policy is short-sighted and will cause further access to care concerns for rural patients,” says NRHA’s Maggie Elehwany. “Rural hospitals already operate at the narrowest of financial margins, and 41% already operate at a loss.”

Sequestration, DSH, bed-debt and other types of cuts have already hit rural hospitals hard.

Forty-seven rural hospitals have closed since 2010. And 283 more are on the verge of closure. If this occurs, 700,000 rural patients will be without access to their closest point of emergency care.

“We hope President Obama will recognize the importance of critical access hospitals and stop calling for cuts to these vital facilities,” Elehwany says.

NRHA is also disappointed that the president again has zeroed out funding for Area Health Education Centers, which provide valuable recruitment and training for quality medical staff to stay in or transfer to rural areas.

More than 90 percent of the rural counties in this nation are designated health professional shortage areas.

“AHECs do much to improve workforce shortages where the need is the greatest: in rural America,” Elehwany adds.

She’ll further discuss the president’s budget and NRHA’s congressional asks tomorrow as part of NRHA’s 26th annual Rural Health Policy Institute, which has brought a record 430 advocates to DC this week and is preparing them for meetings with elected officials on Capitol Hill tomorrow afternoon.

NRHA applauds CMS for reconsidering meaningful-use requirements

In response to concerns from the National Rural Health Association and other provider advocacy groups, CMS will reconsider its policies on meaningful-use (MU) requirements for providers.

CMS Chief Medical Officer Patrick Conway, MD, announced today that CMS will:

  • Realign hospital electronic health records (EHR) reporting periods to the calendar year to allow eligible hospitals more time to incorporate 2014 edition software into their workflows and to better align with other CMS quality programs.
  • Modify other aspects of the program to match long-term goals, reduce complexity and lessen providers’ reporting burdens.
  • Shorten the EHR reporting period in 2015 to 90 days to accommodate these changes.

NRHA has been working with Congress to initiate legislation that would accomplish these goals. NRHA thanks members of Congress who stood with us in protecting rural providers who would have not met onerous 2015 Stage II MU guidelines, which included a full year of reporting requirements. NRHA will continue to monitor these details as the rule comes out this spring.

Conway will speak at NRHA’s 26th annual Rural Health Policy Institute next week in D.C. on this and other important news from CMS. There is still time to register for this premier rural policy event.

Senators introduce bipartisan CAH Relief Act

The National Rural Health Association applauds Sens. Pat Roberts (R-Kan.) and Jon Tester (D-Mont.) for introducing the Critical Access Hospital Relief Act this week.

The bill will align critical access hospitals (CAHs) condition of payment with their conditions of participation by removing a hard-hours-cap on patient stays.

CMS currently requires a physician to certify each patient is expected to be discharged or transferred under a 96 hard-hour-cap as part of a CAH’s “condition of payment.”

The Critical Access Hospital Relief Act will ensure that payment policy does not override the congressionally approved conditions of participation and set a new de facto standard for care available in CAHs.

Continued cuts in hospital payments have taken their toll, forcing far too many closures and leaving many of our nation’s most vulnerable populations without timely access to care.

Since 2010, 47 rural hospitals have closed, more than in the previous 10 years combined. And 283 more are on the brink of closure threatening access to 700,000 rural patients.

Roberts will speak about his bill during NRHA’s 26th annual Rural Health Policy Institute next week in D.C. Critical Access Hospital Relief Act cosponsor Sen. Deb Fischer (R-Neb.) will also present at the nation’s largest rural advocacy event.

NRHA applauds senators’ efforts to increase veteran employment

NRHA recently sent a letter to Sens. Mike Enzi (R-Wyo.) and Amy Klobuchar (D-Minn.) thanking them for introducing the Veterans to Paramedics Transition Act and their leadership in this critical area. The bill will streamline civilian paramedic training for veterans who gained emergency medical experience as a result of their military service, making it easier to secure jobs as paramedics.

Far too many rural communities have critical shortages of trained emergency personnel.

At the same time, these communities are home to thousands of men and women who received emergency medical training while serving in the military. Yet, when they return, this military training and experience does not count toward training and certification as civilian paramedics.

This legislation goes far in accelerating and streamlining the transition to civilian employment for returning veterans, allowing them to continue to serve their communities in a new and needed capacity.

NRHA honors congressional rural health champions

The National Rural Health Association, in conjunction with its 26th annual Rural Health Policy Institute, is pleased to announce the winners of its 2015 Legislative Awards, which recognize outstanding leadership in rural health issues by both members of Congress and congressional staff.

This year’s member recipients are Sen. Michael Bennet (D-Colo.), Sen. Charles Grassley (R-Iowa), Rep. Ron Kind (D-Wis.) and Rep. Adrian Smith (R-Neb.).

Rep. Kind will accept his award and speak to more than 400 rural health advocates next week at NRHA’s Policy Institute Feb. 3-5 in D.C.

Staff awards will be presented to Brian Perkins of the Office of Sen. Jerry Moran and Colin Brainard of the Office of Rep. Lynn Jenkins.

“NRHA greatly appreciates the hard work and dedication displayed by this year’s Legislative Award winners,” says Maggie Elehwany, NRHA government affairs and advocacy vice president.

President Obama delivers State of the Union

President Obama is delivering his second to last State of the Union this evening, touting that 10 million uninsured Americans now have health insurance, that health care inflation is at its lowest rate in fifty years and his launch of a Precision Medicine Initiative to cure diseases.

The full text of the speech can be found here.

Following the State of the Union, the president is expected to release the budget in about two weeks. Stay tuned to this blog for the latest appropriations news.

Learn more about the White House’s initiatives by meeting with the Obama administration, as well as the 114th congressional members and national experts at NRHA’s 26th annual Rural Health Policy Institute Feb. 3-5 in D.C. Register here today.