At approximately 2:55 this afternoon, the Senate Finance Committee approved the “Chairman’s Mark” of the SGR Repeal and Medicare Beneficiary Access Improvement Act of 2013. NRHA was successful in making sure that a number of rural provisions were included as amendments and adopted by the Committee. NRHA considers the adoption of these amendments a significant victory.
The bill would permanently repeal the Sustainable Growth Rate (SGR) and permanently extend a number of rural Medicare extenders. NRHA has long fought for a number of Medicare extenders, essential to rural providers, to be extended at current levels in perpetuity. Additionally, NRHA has sought for regulatory burden reduction that would alleviate the burdens placed on various rural providers. A number of amendments offered at today’s mark-up accomplished these purposes.
Among the important actions taken at the hearing, Amendments 117 and 121 were adopted in the Chairman’s Mark at the beginning of the hearing and, therefore, did not require a vote.
Amendment 117 (Thune/Bennet/Enzi/Roberts 1): This amendment would return supervision requirements for outpatient therapy services furnished at Critical Access Hospitals back to “general supervision.” This was the supervision level observed at nearly every CAH prior to 2009.
Amendment 121 (Thune/Wyden/Roberts/Rockefeller/Enzi/Stabenow 5): This amendment would ensure that the new Alternative Payment Models do not interfere with or inhibit the development of telehealth technologies that are critical to the future of delivering care in rural America.
Additionally, the following amendments passed with unanimous voice vote:
Amendment 18 (Schumer/Grassley 1): This amendment would permanently extend, at current levels two crucial rural hospital payments, the Medicare Dependent Hospital program and Low Volume Hospital Adjustment.
Amendment 82 (Grassley 13): This amendment would set a permanent floor on the work component of the Geographic Practice Cost Index (GPCI) at its current level of 1.0 creating a stable and more equitable reimbursement rate for rural physicians.
Amendment 118 (Thune/Casey/Enzi Amendment 2): This amendment would establish demonstration project for telehealth remote patient monitoring services. This demonstration would help show the efficacy remote patient monitoring in keeping patients in their homes rather than in hospitals.
Another rural health amendment, Amendment 90 (Roberts/Enzi 2), was withdrawn by its sponsors after a number of Committee Members promised to petition CMS for regulatory relief from the certification requirement of physicians admitting patients to CAHs that the patient would be discharged or transferred within 96 hours.
NRHA is thankful for the considerable contributions of many rural health advocates in advancing these amendments.
Again, the adoption of these amendments represents significant victories for rural health. The work, however, is not over. The timing of this committee action means that both the Senate and House will be considering full repeal of the SGR and permanent extension of the rural Medicare extenders after the new year. This makes attendance at the 25th Annual Policy Institute critically important. More information on the the Policy Institute is available here.