NRHA applauds the Senate passage of SGR repeal

Last night, the Senate passed HR 2, the Medicare Access and CHIP Reauthorization Act, a passed by the House in March that repeals the Medicare Sustainable Growth Rate (SGR) and replace it with a payment system that promotes a higher quality of care. Six amendments were debated and rejected. The bill passed 92-8 with strong bipartisan support.

The passage of this bill marks the end of the need for an annual fix to the SGR formula that would have resulted in an over 21 percent decrease in physician reimbursement for caring for Medicare patients.

HR 2 includes multiple important programs for rural America. The bill includes a two-year extension of rural Medicare extenders such as the Low-Volume Hospital adjustments, Medicare-Dependent Hospital program, work geographic index floor under the Medicare physician fee schedule, current rural and super-rural ambulance add-on payments, and exceptions process for Medicare therapy caps. The bill also extends funding for two years to community health centers, National Health Service Corps and teaching health centers.

The National Rural Health Association applauds the inclusion of so many programs of importance to rural America. NRHA is pleased that Congress is hearing our message about the importance of rural health care and the need for robust support of programs targeting rural health care.

NRHA announces 2015 Rural Health Award recipients

The National Rural Health Association is proud to announce its 2015 Rural Health Award recipients. The following organizations and individuals will be honored April 16 during NRHA’s 38th Annual Rural Health Conference, which will attract more than 650 rural health professionals and students to Philadelphia.

“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 Program
Rural Behavioral Health Primary Care Collaborative at Western Montana Area Health Education Center

Outstanding Rural Health Program
Innovative Readiness Training Medical Mission, a Delta Regional Authority and U.S. Department of Defense collaborative

Outstanding Rural Health Organization
Sakakawea Medical Center and Coal Country Community Health Center

Louis Gorin Award for Outstanding Achievement in Rural Health
Steven R. Shelton

Rural Health Practitioner of the Year
Wendel Ellis, DO

Outstanding Educator Award
K. Bryant Smalley, PhD, PsyD

Outstanding Researcher Award
Mark Holmes, PhD

NRHA/John Snow Inc. Student Leadership Award
Alex Spencer

View the press release for more information on the honorees and Annual Conference details.

HIV outbreak calls for improved public health in rural America

By Michael Meit, NORC Walsh Center for Rural Health Analysis co-director and NRHA board member, and Brock Slabach, NRHA membership services senior vice president

The HIV outbreak in rural Scott County, Ind., took many by surprise last week. For others, the news was sad but not so surprising.

The combination of rural poverty, lack of rural public health resources and a high uninsured population is manifesting in an epidemic. The devastating truth is it has taken an HIV outbreak to point out these deficiencies. The proverbial chickens have come home to roost.

While rural communities have many assets, some also experience longstanding poverty that results in despair which often can lead to drug abuse. The 80 or more cases of HIV infection in Scott County has been linked to intravenous use of prescription pain medications. The drug of choice in this community was Opana, a long-acting form of Oxymorphone. When altered and injected it produces a powerful high. The chief Indiana health officer told the New York Times: “There’s a feeling of hopelessness within this community. They’re addicted, and they’re getting HIV because they’re addicted.”

While there is a critical need to address the underlying social conditions that lead to this sense of hopelessness, we also need to ensure that our rural communities have the health care, public health and social services resources necessary to prevent substance abuse, treat addiction, and identify and contain infectious and communicable diseases.

Our rural communities bring much to the table in addressing these challenges, including strong social networks, a culture of self-sufficiency, and robust faith communities. At the same time, however, America’s rural community systems need proper investment, training and technical assistance to effectively leverage these assets and ensure the health and wellbeing of the people they serve.

It is heartbreaking that a preventable disease like HIV has to be epidemic before it highlights what the National Rural Health Association and public health professionals have been saying for decades: Investment in both the economic and public health of rural communities is essential.

State and local governments have been slashing public health and social services funds for several years, particularly following the economic recession. At the same time, federal resources have also declined. This results in rural communities being more reliant on federal funds as an overall proportion of their budgets, even as their overall budgets have dwindled.

Together, these cuts have both decreased available funding to address social and public health issues in our rural communities, while impeding the flexibility rural areas have to address the unique issues they face. Yes, the chickens have come home to roost due to years of neglect. Let’s use this tragedy to change policy and ensure that this is the last epidemic we have to endure.

Help advance rural public health during NRHA’s Annual Rural Health Conference in two weeks, and learn about drug abuse intervention and HIV prevention and treatment efforts specific to rural areas.

Senate delivers rural hospital and VA victories, but punts SGR

Among the amendments passed to the Senate Budget Resolution (S. Con. Res. 11) early Friday, was the National Rural Health Association-supported amendment No. 356 to allow the VA to provide veterans access to non-VA health care services when the nearest VA medical facility within 40 miles from a veteran’s home is unable to offer appropriate care for the veteran.

The amendment, which passed 100-0, was authored by Sen. Jerry Moran (R-Kan.) and allows rural veterans to have quality, timely care in their rural communities.

The budget also included language to make permanent the Medicare-dependent hospital (MDH) program and the low-volume hospital (LVH) adjustments. The House passed its own budget this week, and the two versions will need to be reconciled.

NRHA is also pleased with this week’s passage of the Medicare Access and CHIP Reauthorization Act in the House, which was the first step to ensuring the seamless continuation of multiple programs of importance to rural America. The bill provides for a repeal of the flawed physician Medicare payment formula known as the Sustainable Growth Rate (SGR) and replaces it with a payment system that promotes a higher quality of care.

Of particular importance to rural America, the bill also includes a two-year extension of the LVH, MDH, work geographic index floor under the Medicare physician fee schedule, current rural and super-rural ambulance add-on payments, an exceptions process for Medicare therapy caps, community health centers, National Health Service Corps teaching health centers, and the Children’s Health Insurance Program (CHIP).

The Senate did not vote on the Medicare and CHIP Reauthorization Act before leaving for recess, but is expected to take action upon returning to Washington.  NRHA is disappointed with the Senate’s decision to punt the SGR vote and leave physicians facing a 21 percent cut in Medicare reimbursements at the end of the month. According to the Centers for Medicare and Medicaid Services, “services rendered on or before March 31, 2015, are unaffected by the payment cut and will be processed and paid under normal procedures and time frames.” NRHA urges Congress to ensure these cuts do not take effect.

NRHA will continue to advocate strong funding for the rural health safety net. Members of Congress just began a two-week recess, and the timing is crucial. Your elected officials must hear from you in support of critical rural health programs. Contact your senators and representatives today to set up a visit and invite them to your facility. Speak up at a town hall meeting, and let them know how vital these programs are to your facility and your community.

And register today to learn more about emerging issues in rural Medicare policy at NRHA’s 38th Annual Rural Health Conference in Philadelphia.

NRHA applauds House passage of vital rural health programs, asks Senate to act now

Today, the House passed HR 2, the Medicare Access and CHIP Reauthorization Act, with a strong bipartisan vote of 392 to 37. The President has indicated he will sign this bill into law when it reaches his desk.

Though strong support for the bill is building in the Senate, they have yet to schedule a vote. And they will begin a two-week recess this week, not returning until the after the March 31 deadline has passed on these programs that are critical to rural patients and providers.

The passage of HR 2 in the House is the first step to ensuring the seamless continuation of multiple programs of importance to rural America. The bill provides for a repeal of Medicare’s Sustainable Growth Rate (SGR) and to replace it with a payment system that promotes a higher quality of care.

Of particular importance to rural America, it also includes a two-year extension of the Low-Volume Hospital adjustments, Medicare-Dependent Hospital program, work geographic index floor under the Medicare physician fee schedule, current rural and super-rural ambulance add-on payments, exceptions process for Medicare therapy caps, community health centers, National Health Service Corps teaching health centers, and the Children’s Health Insurance Program (CHIP).

But we need the Senate to act quickly. Call your senators today. Let them know just how important these programs are for rural Americans. Tell Congress to pass HR 2 before recess.

SGR replacement package continues to move forward

The House rules committee met this afternoon to discuss HR 2, the Medicare Access and CHIP Reauthorization Act. This bipartisan bill will repeal Medicare’s Sustainable Growth Rate (SGR) and replace it with a payment system that promotes a higher quality of care, developed as a result of bipartisan, bicameral agreement. It extends important rural Medicare extenders and the Children’s Health Insurance Program (CHIP) for two years.

H.R. 2 is expected to be on the House floor first thing tomorrow, with a vote anticipated just after noon. The President has said he’s ready to sign this bill into law. The Senate has yet to schedule a vote.

HR 2 includes multiple important programs for rural America. The bill includes a two-year extension of rural Medicare extenders such as the Low-Volume Hospital adjustments, Medicare-Dependent Hospital program, work geographic index floor under the Medicare physician fee schedule, current rural and super-rural ambulance add-on payments, and exceptions process for Medicare therapy caps.

Without congressional actions, these extenders expire on March 31. The bill also extends funding for two years to community health centers, National Health Service Corps and teaching health centers.

The National Rural Health Association has diligently worked to get the message to Congress of the importance of rural health care. And based on the inclusion of so many programs of importance to rural America, Congress has heard us.

Now, we need your help. Contact your member of Congress today. Let them know just how important these programs are for rural Americans. Tell Congress to act before the March 31 deadline to pass HR 2.

Rural Medicare extenders to expire next week

Today, the House released HR 2, the Medicare Access and CHIP Reauthorization Act, which includes important rural provisions. This bipartisan bill will repeal Medicare’s Sustainable Growth Rate (SGR) and replace it with a payment system that promotes a higher quality of care, developed as a result of bipartisan, bicameral agreement. It extends important rural Medicare extenders and the Children’s Health Insurance Program (CHIP) for two years. The House is expected to vote on H.R. 2 this week.

In the past 12 years, Congress has passed 17 temporary patches of the SGR. And again, without congressional action by March 31, the SGR will slash physician payments by nearly 22 percent.

A number of important Medicare extenders will also expire March 31 if Congress doesn’t act soon. Of particular concern for rural providers are the Low-Volume Hospital adjustments, Medicare-Dependent Hospital program, work geographic index floor under the Medicare physician fee schedule, current rural and super-rural ambulance add-on payments, and exceptions process for Medicare therapy caps.

The National Rural Health Association has been actively working with Congress to ensure these important Medicare extenders are included in legislation related to the SGR. The legislation released today extends these vital rural programs for two years. This extension is in line with the CHIP extension, providing an important legislative vehicle for future extensions. The bill also extends funding for two years to Community Health Centers, National Health Service Cops, and Teaching Health Centers. Clearly, Congress has heard NRHA’s message.

But the work isn’t finished yet. Contact your member of Congress today. Let them know just how important these programs are for health care in rural America. Tell Congress to act before the March 31 deadline to pass HR 2.

And join NRHA for a grassroots advocacy webinar on HR 2 and more at 11 a.m. CDT Wednesday, March 25.

And register today to learn more about emerging issues in rural Medicare policy at NRHA’s 38th Annual Rural Health Conference in Philadelphia.

Permanent extension of MDH, LVH programs included in Senate budget

The National Rural Health Association is pleased that the proposed Senate Republican budget released this week included several important rural provisions, including an amendment introduced by Senator Chuck Grassley (R-IA) that would make the Medicare Dependent and Low-Volume Hospital programs permanent. Unless Congress acts, these important rural designations expire at the end of the month.

Another important rural provision in the budget would allow for Medicare payments for pharmacists to offer health and wellness screenings, immunizations, and diabetes management where pharmacists are already licensed under state law to provide these services. This important change championed by Sen. Grassley would expand health services in rural America by using health professionals already practicing in rural communities.

NRHA applauds the efforts of Sen. Grassley, a true champion of rural. NRHA supports a budget that promotes important rural health care programs.

House to vote on bipartisan health care bills important for rural health

This evening, the House is set to vote on a number of health care related bills from the Ways and Means and Energy and Commerce committees. Of particular interest for rural health care are two trauma bills and one about volunteer firefighters and emergency first responders.

We all know that rural populations are less likely to have access to trauma care locally. Yet, access to trauma care can be the difference between life and death. Today the House is expected to pass under suspension of the rules two important bills to improve access to trauma care: H.R. 647 – Access to Life-Saving Trauma Care for All Americans Act and H.R. 648 – Trauma Systems and Regionalization of Emergency Care Reauthorization Act. With these bills the House explicitly affirms the importance of access to trauma care for rural Americans.

With so many rural communities relying heavily on volunteer firefighters and emergency responders, H.R. 1191 provides an important exemption from counting these volunteers as employees under the Affordable Care Act. This bill will protect local communities that rely on their volunteer emergency service providers from paying penalties or having to find money in already tight local government budgets to provide an offer of health insurance to volunteers that often already have insurance offered through their employers. This protection was passed by the House in the 113th Congress but failed to make it to the President’s desk.

Three additional bills will improve regulatory transparency for new medical therapies (H.R. 639), ensure Medicare beneficiaries are aware when they are on observation stay (H.R. 876), and addressed certain issues with durable medical equipment bidding (H.R. 284).

After passage in the House, these bills will hopefully be quickly taken up in the Senate.

Contact your members of Congress today and let them know how important these bills are for Rural America.

Former NRHA member takes No. 2 spot at HHS

wakefieldThe National Rural Health Association is pleased that former NRHA member and longtime rural health advocate Mary Wakefield will serve as acting deputy administrator of the Department of Health and Human Services (HHS).

“We are thrilled to see such a strong rural advocate assume a key position within HHS,” said Alan Morgan, NRHA CEO. “Dr. Wakefield is a stalwart champion for rural health within the administration.”

Just after Thursday’s announcement, Wakefield, a nurse from North Dakota, confirmed that rural health will continue to be one of her priorities.

She has led the Health Resources and Services Administration for the past five years.

HHS Secretary Sylvia Mathews Burwell praised Wakefield’s ability to lead “through a time of marked transformation.”

“She has improved access to health for millions of patients, strengthening America’s health care workforce,” she wrote.

Jim Macrae, currently the associate administrator for primary health care, will serve as HRSA’s acting administrator.

“He will certainly be a great person to work with as we move forward,” Morgan said.