NRHA is pleased that Senators Claire McCaskill and Tom Coburn are renewing their push to repeal the piece of the health law that resulted in a wage increase for all Massachusetts hospital physicians and staff at the detriment of rural hospitals across the nation.

The provision required that Medicare reimbursements to all providers in a state be higher than the wage at the state’s rural hospitals. Massachusetts has only one “rural” hospital to set that floor, resulting in all wages in the state rising at the expense of other states. The lawmakers say that nine states benefit from the provision and 40 see a negative impact.

The provision was dubbed the “Bay State Boondoggle.” The bill already has 24 co-sponsors.  If you don’t see your senator listed below, please call 202-224-3121 and ask your senator to cosponsor S.183, the Hospital Payment Fairness Act of 2013.

Sen Baldwin, Tammy [WI] – 3/22/2013
Sen Blunt, Roy [MO] – 2/7/2013
Sen Brown, Sherrod [OH] – 2/25/2013
Sen Burr, Richard [NC] – 2/4/2013
Sen Chambliss, Saxby [GA] – 2/4/2013
Sen Coburn, Tom [OK] – 1/30/2013
Sen Enzi, Michael B. [WY] – 2/13/2013
Sen Franken, Al [MN] – 3/12/2013
Sen Grassley, Chuck [IA] – 2/11/2013
Sen Hagan, Kay [NC] – 1/31/2013
Sen Inhofe, James M. [OK] – 2/11/2013
Sen Isakson, Johnny [GA] – 2/7/2013
Sen Kaine, Tim [VA] – 3/11/2013
Sen Klobuchar, Amy [MN] – 3/5/2013
Sen McConnell, Mitch [KY] – 1/31/2013
Sen Merkley, Jeff [OR] – 2/26/2013
Sen Moran, Jerry [KS] – 2/7/2013
Sen Portman, Rob [OH] – 3/7/2013
Sen Pryor, Mark L. [AR] – 2/7/2013
Sen Roberts, Pat [KS] – 2/14/2013
Sen Shelby, Richard C. [AL] – 4/11/2013
Sen Vitter, David [LA] – 2/14/2013
Sen Warner, Mark R. [VA] – 1/31/2013
Sen Wicker, Roger F. [MS] – 5/23/2013

In an article published by the Washington Post on Saturday, reporter David Fahrenthold examined the multiple definitions of “rural” used by the federal government.  In the story, Mr. Fahrenthold looked at the various definitions used by the Department of Agriculture, Department of Health and Human Services, the Consumer Financial Protection Bureau, and others. Many of these definitions are used to establish criteria for grant programs in several Departments, inclusion in health programs, and many building programs.

According to official policies passed by NRHA’s Rural Health Congress, “The National Rural Health Association strongly recommends that definitions of rural be specific to the purposes of the programs in which they are used and that these are referred to as programmatic designations and not as definitions. Programs targeting rural communities, rural providers, and rural residents do so for particular reasons, and those reasons should be the guidance for selecting the criteria for a programmatic designation (from among various criteria and existing definitions, each with its own statistical validity). This will ensure that a designation is appropriate for a specific program while limiting the possibilities that other unrelated programs adopt a definition, which is not created to fit that program.”

To read the entire Washington Post story, click here.  For more information on the policies of NRHA, click here.

On Monday, June 3, NRHA Vice President of Government Affairs, Maggie Elehwany, participated in The National Mental Health Conference at the White House with President Barack Obama and Vice President Joe Biden. The Conference was touted as “part of the Administration’s effort to launch a national conversation to increase understanding and awareness about mental health.” In addition to NRHA, the conference brought together stakeholders from throughout the country, including mental health advocates, educators, health care providers, faith leaders, members of Congress, representatives from local governments and individuals who have struggled with mental health problems.

According to recent studies, rural America is disproportionately impacted by mental health conditions with higher levels of depression, domestic violence, and child abuse than their urban counterparts. Rural residents also face distinct challenges in accessing mental health services including physical, cultural, and financial barriers. As a result, they tend to seek mental health services later, have greater symptoms, and require more intensive treatment. Furthermore, of the 3,800 mental health professional shortage areas in the United States, 85% are located in a rural area.

NRHA applauds the Administration’s renewed focus on mental health, specifically in rural communities and remains committed to increasing the access to and utilization of mental health services in all rural communities.

Two articles in the recent issue of NRHA’s quarterly magazine Rural Roads highlight this rural relevant issue.

The Senate Judiciary Committee approved a bipartisan immigration bill last week which included significant provisions for physicians and nurses, including a provision that would permanently reauthorize the Conrad 30 Waiver program. 

The National Rural Health Association (NRHA) supports the Conrad 30 Waiver Program, which makes great strides in the recruitment of physicians to rural areas and the delivery of vital health care services in rural America. This program will help hospitals, clinics and group practices increase access to health care in rural America.

NRHA will continue to support all programs that expand access to all health care providers in rural America.

The National Rural Health Association is proud to announce its 2013 Rural Health Award recipients. The following organizations and individuals will be honored May 9 during NRHA’s 36th Annual Rural Health Conference, which will attract more than 900 rural health professionals and students to Louisville, Ky.

“We’re proud of this year’s winners,” says Alan Morgan, NRHA CEO. “They have each already made tremendous strides to advance rural health care, and we’re confident they will continue to help improve the lives of rural Americans.”

And the winners are…

Outstanding Rural Health Organization
Arizona Center for Rural Health

Rural Health Quality Award
Gibson Area Hospital and Health Services

Outstanding Rural Health Program
University of Alabama Rural Health Leaders Pipeline

Louis Gorin Award for Outstanding Achievement in Rural Health
Charlie Alfero

Rural Health Practitioner of the Year
Larry Rhodes, MD

Outstanding Researcher Award
George Pink, PhD

Student Leadership Award
Erin Locke

Student Achievement Award
Ian Stormont

Here’s a press release with more information on the honorees, and Annual Conference details are available here.

On Monday, April 29, NRHA Vice President of Program Services, Amy Elizondo, participated in the White House Forum on Military Credentialing and Licensing.  NRHA was invited to take part in the Advanced Medical Occupations Roundtable as part of the forum.

The forum stemmed from First Lady Michelle Obama’s and Dr. Jill Biden’s Joining Forces campaign they started two years ago in support of veterans and military families. The First Lady welcomed participants as this particular forum focused on improving veterans’ transition to civilian health careers. Dr. Mary Wakefield, administrator for the Health Resources and Services Administration, moderated the discussion, which also included opening remarks from Health and Human Services Secretary Kathleen Sebelius.

The discussion focused on three key areas: 1) adapting civilian education to build on military training and experience, 2) improving strategies for veterans and 3) streamlining licensure for veterans.  

As roughly 31 percent of the enrolled veterans who served in Iraq and Afghanistan are returning to their rural communities according the Veterans Health Affairs Office of Rural Health, NRHA is looking to collaborate with military and other health organization partners to help translate veterans’ health training skills to assist with workforce issues in rural areas. 

NRHA contributed to the discussion by offering the opportunity to collaborate and working toward meeting the needs of returning veterans while simultaneously helping meet the needs of rural America. Follow up steps were established, and NRHA will provide updates. For more information on the issue, visit The Fast Track to Employment: Streamlining Credentialing and Licensing for Service Members, Veterans, and their Spouses and attend NRHA’s 36^th Annual Rural Health Conference next week in Louisville, Ky., which will feature sessions on both rural health workforce issues and innovative projects to advance veterans health.

At a Senate Appropriations Subcommittee hearing on the President’s budget currently underway, several Senators expressed concern over proposed cuts to Critical Access Hospitals (CAHs).  The President’s budget proposes to alter the CAH program in two ways.  First, facilities designated by their states as “necessary providers” that are located less than ten miles from another facility would lose their status, regardless of community need, the type of facility less than ten miles from them,  or the reason the state’s governor designated them as necessary providers.  Second, the budget calls for reducing reimbursement for all CAHs from 101% of “reasonable costs” to 100% of reasonable costs.

At the hearing, Secretary Sebelius was questioned about this reduction by Senators Jerry Moran (R-KS), Mark Pryor (D-AR), Thad Cochran (R-MS), and John Boozman (R-AR).  Senator Moran raised many critical questions about the current fiscal challenges at many CAHs and the effect such cuts would have on the rural health safety net.  Senator Moran quoted the National Rural Health Association in his exchange with the Secretary and called on the Administration to reconsider this recommendation.

The Subcommittee will soon post a recap of the hearing and video of the testimony on their website.

Seventy-seven members of Congress sent a “Dear Colleague” letter to the Appropriations Subcommittee on Labor, HHS, Education, and Related Agencies in support of $280 million for HRSA’s Title VII health professions programs in Fiscal Year (FY) 2014. The letter outlines how important these programs are for health care workforce development and education.

Representatives Diana DeGette (D-CO) and Mike Burgess (R-TX) cosponsored the letter and NRHA applauds them for leading the effort to sustain these programs that provide critical support to the rural health care safety net.

A copy of the final letter is available here.

At a Senate Finance Committee hearing on the President’s budget request for federal fiscal year 2014 yesterday, Senator Pat Roberts (R-KS) asked Secretary Sebelius about the repeated calls from the administration to strip some facilities of their Critical Access Hospital (CAH) status and lower reimbursement rates for all CAH facilities. Specifically, the budget calls for decreasing payments to CAHs from 101% of reasonable costs to 100% of reasonable costs. Furthermore, the President proposes to eliminate CAH status for facilities 10 miles away, or less, from another facility.  Secretary Sebelius said that she “shared (the Senator’s) concerns about the importance of Critical Access Hospitals” and promised to follow-up with the Senator’s office about his concerns with the cuts.

NRHA applauds Senator Roberts for his continued work to protect and strengthen the Critical Access Hospital system.

For a full copy of the President’s budget, click here. To watch the Senate hearing and Senator Roberts’ question, click here.