Author Archives: Erin Mahn Zumbrun

AAFP endorses H.R. 3225, the Save Rural Hospitals Act

The National Rural Health Association applauds the American Academy of Family Physicians (AAFP), which represents 124,900 family physicians and medical students across the country, for supporting the Save Rural Hospitals Act.

In a letter to the bill’s cosponsors, Reps. Sam Graves (R-MO) and Dave Loebsack (D-IA), AAFP acknowledges the unique challenges faced by rural hospitals and recognizes the payment inequities that rural hospitals operate under and believes that they should be abolished.

Seventy-six rural hospital have close since 2010. Even more concerning is the 673 additional vulnerable rural hospitals, which equates to one-third of all rural hospitals in the U.S., are at risk of closure. These closures are a result of continued Medicare cuts in hospital payments. Rural hospitals are especially critical because the 62 million Americans who call rural America home are older, sicker, and poorer than their urban counterparts. These hospital closures have devastated rural communities and left residents with inadequate access to essential health care services.

The solution is legislation. NRHA urges members of Congress to co-sponsor this important legislation. NRHA also asks the Senate to introduce a companion bill. The Save Rural Hospitals Act will stop the flood of rural hospital closures and provide needed access to care for rural Americans. The bill will stabilize rural hospitals by reversing cuts that are devastating rural hospitals including “bad debt” reimbursement cuts, permanently extending current Low-Volume and Medicare Dependent Hospital payment levels, and eliminating Medicare and Medicaid DSH payment reductions.

The bill will provide regulatory relief by eliminating the CAH 96-Hour condition of payment, rebasing the supervision requirements for outpatient therapy services at CAHs and rural PPS facilities, and modifying the 2-Midnight Rule and RAC audit and appeals process. The bill also looks to the future to create an innovative delivery model that will ensure emergency access to care and allow hospitals the choice to offer outpatient care that meets the health needs of their rural community with a payment structure that will allow these hospitals to remain open and serving their communities.

NRHA applauds Senate Appropriations Committee for rural funding

The National Rural Health Association applauds the Senate Appropriations Committee for recognizing the importance of a strong investment in rural health delivery for fiscal year 2017.

NRHA thanks Chairman Cochran, Vice Chairwoman Mikulski, and the Committee members for the increase of funding for the Rural Outreach and Network Grants and Telehealth, both important programs for rural America. NRHA also applauds the Committee for the strong funding for the Rural Hospital Flexibility Grants which are used by each state to implement new technologies, strategies and plans in Critical Access Hospitals (CAHs). CAHs provide essential services to a community and their continued viability is critical for access to care and the health of the rural economy.

NRHA also thanks the Committee for recognizing the importance of Graduate Medical Education (GME), and its concern that the current funding for GME does not adequately address the needs of rural communities and the changing demands on the health care system. NRHA applauds the Committee for directing CMS to submit a report to Congress on what steps can be taken to address physician shortages.

Rural health programs assist rural communities in maintaining and building a strong health care delivery system into the future. Most importantly, these programs help increase the capacity of the rural health care delivery system and true safety net providers.

Programs in the rural health safety net increase access to health care, help communities create new health programs for those in need and train the future health professionals that will care for the 62 million rural Americans. With modest investments, these programs evaluate, study and implement quality improvement programs and health information technology systems.

Funding for the rural health safety net is more important than ever as rural Americans are facing a hospital closure crisis. Since 2010, 75 rural hospitals have closed, 10,000 rural jobs have been lost and 1.2 million rural patients have lost access to their nearest hospital. The most recent hospital closed in Georgia on Monday. Even more concerning is that 673 rural hospitals are at risk of closure, meaning sustained Medicare cuts threaten the financial viability of 1 in 3 rural hospitals. The loss of these hospitals would mean 11.7 million patients would lose access to care in their community.

NRHA asks Congress to support strong funding for these important rural health programs.

Rural broadband bill heads to president’s desk

The National Rural Health Association applauds the passage of S. 1916, the Rural Health Care Connectivity Act, which will expand the Universal Service Fund’s (USF) Rural Health Care Program (RHCP) to skilled nursing facilities (SNF).  This program provides funding for telecommunications and broadband services used to provide health care in rural communities. SNFs are an important source of health care for many seniors in rural America, and this bill will help these facilities have access to the broadband and telecommunications services that are so important to providing the care their patients need.

This important legislation sponsored by rural champion Sen. John Thune (R-SD), was included in the Toxic Substances Control Act conference report. The president is expected to sign the conference report.

Rep. Ryan selected as nominee for Speaker

Rep. Paul Ryan (R-WI) was selected as the nominee for Speaker of the House today by the House Republicans. Rep. Ryan defeated Rep. Daniel Webster (R-FL) during a closed-door election of the House Republican Conference.

Rep. Ryan is expected to be ratified by the full House Thursday. He will replace John Boehner  (R-OH) who will be stepping down later this week.

NRHA disappointed in tentative budget deal

Late Monday night, Congressional leaders and the White House reached a tentative budget deal that would raise the debt limit, avoid a shutdown in December, and would set spending levels through September 2017.

The National Rural Health Association is disappointed that the Bipartisan Budget Act of 2015 includes site-neutral payment cuts on hospital outpatient departments (HOPDs) and the extension of sequestration for Medicare payments. Rural hospitals play a critical role in providing 24/7 access to care and are the safety net providers for rural America.

The extension of the 2 percent cut in Medicare payments, which was first passed under the sequester, comes during a time when rural hospitals are already closing because of drastic cuts.

“Rural hospitals are closing at a record rate,” says Maggie Elehwany, NRHA’s vice president of government affairs. “We have seen 57 rural hospitals close since 2010, and another 283 rural hospitals are on the brink. Since the start of 2013, more rural hospitals have closed than in the previous 10 years combined, and rural communities across the nation are feeling the crisis in tragic ways. Our rural hospitals cannot shoulder any more cuts.”

The deal would provide $50 billion in fiscal year 2016 and $30 billion in fiscal year 2017 in sequester relief for both defense and non-defense spending, but hospitals would be left out in the cold.  Raising spending now in return for cuts further down the road has serious consequences for hospitals and providers that depend on Medicare reimbursements to keep their doors open to serve the older, poorer and sicker rural population.

NRHA will continue to advocate for strong funding for the rural health care safety net. Members of Congress must hear from you in support of critical rural health programs and to protect access points that will be impacted by this deal. Continue to follow NRHA’s blog for the latest news from Capitol Hill.

Join the fight to protect health care in your community. Contact your members of Congress today and let them know how important your facility is to your community. And plan now to meet with the Obama administration, your congressional members and national experts at NRHA’s 27th annual Rural Health Policy Institute Feb. 2-4 in D.C. Rural America is counting on you. Register today and save $100.

McCarthy withdraws from speaker election

Rep. Kevin McCarthy (R-Calif.) has withdrawn from the race for speaker of the House of Representatives. The election has been postponed.

House Speaker John Boehner (R-OH) will continue to serve in the position until the House elects a new speaker. Rep. Boehner announced in September that he will resign from Congress at the end of this month.

White House names Rural IMPACT demonstration sites

The White House today announced the 10 sites participating in the Rural IMPACT demonstration, an initiative to help address rural child poverty. More than six million rural Americans live in poverty, including about 1.5 million children.

The 10 rural and tribal communities participating in the demonstration are:

  • Berea (KY), Partners for Education at Berea College (Serving Knox County, KY)
  • Blanding (UT), The San Juan Foundation (Serving San Juan County, UT)
  • Blytheville (AR), Mississippi County, Arkansas Economic Opportunity Commission, Inc. (Serving Mississippi County, AR)
  • Hillsboro (OH), Highland County Community Action Organization, Inc. (Serving Highland County, OH)
  • Hugo (OK), Little Dixie Community Action Agency, Inc. (Serving Choctaw, McCurtain and Pushmataha Counties)
  • Jackson (MS), Friends of Children of Mississippi, Inc. (Serving Issaquena, Sharkey and Humphreys Counties, MS)
  • Machias (ME), Community Caring Collaborative (Serving Washington County, ME)
  • Marshalltown (IA), Mid‐Iowa Community Action, Inc. (Serving Marshalltown, IA)
  • Oakland (MD), Garrett County Community Action Committee and the Allegany Human Resources Commission (Serving Garrett and Allegany Counties, MD)
  • White Earth (MN), White Earth Reservation Tribal Council (Serving Mahnomen County and portions of Clearwater and Becker Counties)

House Speaker John Boehner to resign

House Speaker John A. Boehner (R-Ohio) announced today he will resign from Congress at the end of October.

Rep. Boehner was elected to Congress in 1990. He has served as Speaker since the Republicans took control of the House of Representatives following the 2010 midterm elections.  Previously, he served as House Majority Leader.

Short-term CR introduced in Senate

The Senate introduced a continuing resolution this afternoon that would keep the federal government running through Dec. 11. The bill continues spending at the Fiscal Year 2015 levels minus .21 percent, the necessary cut to stay below the sequester cap.

The bill contains language defunding Planned Parenthood for one year and redirecting mandatory funds to community health centers.

The Senate will vote on Thursday. According to reports, the Democrats are expected to filibuster and the bill is expected to fail.

There are only five working days left before the end of the fiscal year. Continue monitoring this blog for the latest news from Capitol Hill.

Save Rural Hospital Act needs your help: Urge your representative to sign on as a co-sponsor today

The National Rural Health Association encourages you, and all rural health leaders across the country, to contact their member of Congress and urge them to cosponsor HR 3225, the Save Rural Hospitals Act.

Members of Congress are home in their districts for the next two weeks, so now is the time to reach out to them.

HR 3225 will stop the flood of rural hospital closures by ending Medicare cuts to rural hospital and eliminating burdensome regulatory requirements. The bipartisan bill also offers a path forward for rural hospitals that may still continue to struggle by allowing them to transform into an innovative new payment model that fits the unique delivery needs of a rural community.

This is urgent. Fifty-six rural hospitals have closed, and 283 additional hospitals on the brink of closure.

NRHA asks you to visit the district office, attend town hall meetings and invite your member of Congress to tour your rural facilities. Explain to them how important your hospital is to the patients you serve and the rural economy. Don’t wait. HR 3225 will eliminate millions in Medicare dollars that have been cut from your hospital. America’s rural safety net hospitals needs this bill passed now.

Visit for more information on the HR 3225, the Save Rural Hospitals Act, and how you can help get this important bill passed.