Author Archives: Erin Mahn

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.

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.

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.

Tavenner resigns from CMS

Marilyn Tavenner, the Administrator for the Centers for Medicare & Medicaid Services, is stepping down next month. In her role as administrator, Tavenner oversaw the implementation of the Affordable Care Act.  She will be replaced on an interim basis by Andrew Slavitt, the Principal Deputy Administrator at CMS.

Prior to CMS, Tavenner was the Commonwealth of Virginia’s Secretary of Health and Human Resources under former Governor Tim Kaine. She began her career working as a nurse in Richmond, Va.

Rural Americans see high insurance premiums

Rural Americans are seeing the highest premiums through insurance marketplaces created by the Affordable Care Act, according to a new study released by the Kaiser Family Foundation.

The top ten highest premiums include Alaska ($488), Wyoming ($440), rural Nevada ($418) and inland California ($410). Ithaca, N.Y. ($459) and Bay St. Louis, Miss. ($456) were the two highest cities.  The lowest premiums were in Phoenix, Ariz. ($166), Albuquerque, N.M. ($167) and Louisville, Ky. ($167).

The Kaiser Family Foundation found that the national premium for a 40-year-old is $269.

The full report can be found here.

Learn the latest news about the Affordable Care Act, and meet with the Obama administration, 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.


Critical Access Hospital Relief Act Introduced

Representatives Adrian Smith (R-NE), Greg Walden (R-OR), David Loebsack (D-IA) and Todd Young (R-IN) have introduced the H.R. 169, the Critical Access Hospital Relief Act. This bill would eliminate the current Condition of Payment requirement that physicians at Critical Access Hospitals certify, at the time of admission, that Medicare and Medicaid patients will not be at the facility for more than 96 hours. This important legislation will go far in helping alleviate unnecessary red-tape for Critical Access Hospitals throughout the nation.  NRHA commends these rural health champions for their leadership and encourages Congress to act quickly to pass this legislation.

114th congress convenes

Today marks the first day that the 114th Congress takes office. Republicans control both chambers for the first time in eight years.

As members of Congress begin work, so does our work at the National Rural Health Association. Last year, rural health care faced its greatest challenge:  Forty-three rural hospitals have closed; 283 more are on the brink of closure.  Continued cuts in hospital payments have taken their toll, forcing far too many closures and leaving some of our nation’s most vulnerable populations without timely access to care.

What can the new Congress do to protect the 20 million rural Americans dependent on these rural hospitals for care? Stop the hundreds of millions of dollars in cuts to rural hospitals and providers.

Urge members of Congress to protect the rural health care safety net. Don’t miss the chance to meet with the Obama administration, 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.

President Obama signed into law H.R. 4067

President Obama signed into law H.R. 4067, which will extend to all of calendar year 2014 the enforcement moratorium on the outpatient therapeutic services “direct supervision” policy for Critical Access Hospitals (CAHs) and rural prospective payment system hospitals with 100 or fewer beds.

H.R. 4067 was introduced by Senator Jerry Moran (R-KS) and Congresswoman Jenkins (R-KS) and passed both the House and Senate. The National Rural Hospital applauds the leadership of Sen. Moran and Rep. Jenkins for this important bill for CAHs and small rural hospitals.

Documentary “Remote Area Medical” to Screen in Washington with Special Appearance by NRHA CEO Alan Morgan

The National Rural Health Association invites you to the screening of the documentary Remote Area Medical. The film will screen at West End Cinema on December 5th at 7 p.m. and is the Washington premiere. Alan Morgan, NRHA CEO, will be a special guest and he will provide a lively discussion after the film.

Praised as “bittersweet…poignant. Those stories aren’t unlike a country ballad, and are arranged with a sensitivity to detail and the lives behind them, though not without interludes of rough humor by The Wall Street Journal, Jeff Reichert and Farihah Zaman’s documentary follows a three-day clinic held at the Bristol Motor Speedway in Tennessee and shows what it means when rural America does not have the access it needs to sufficient healthcare.

“This film is a glimpse into the lives of everyday rural Americans who struggle to access care,” Alan Morgan, CEO of the National Rural Health Association said. “Rural Americans, on average, are poorer, sicker and older than their urban counterparts. Remote Area Medical is a compelling story of those desperate for medical care.”

Filmmaker Jeff Reichert will also be appearing for a Q&A. The film won the Founders Prize for Best Documentary at the 2013 Traverse City Film Festival.

Film screening and discussion of Remote Area Medical will be held at the West End Cinema in Washington, DC at 7 p.m. on December 5. The film is open to the public; for tickets visit To view the trailer, visit:

NRHA is thankful for rural victories

As Thanksgiving is around the corner, the National Rural Health Association is thankful for the many rural victories we have had to celebrate National Rural Health Day. National Rural Health Day has grown and is being recognized on Capitol Hill like never before.  Several significant speeches were given on both the House and Senate Floor.  Additionally, with the passage of the Senate Resolution and the direct supervision bill, this National Rural Health Day is our most successful to date.

Here are a few highlights of last Thursday:

S. Res. 588 (formerly S. Res. 26.) passes in the Senate.  On the evening of National Rural Health Day, Senators Moran (R-KS) and Klobuchar (D-MN) pushed to pass a resolution detailing the importance of rural hospitals and rural providers to patients and the rural economy.  Additionally, it outlines how important it is to provide fair reimbursement to those rural providers.  NRHA is thankful for Senators Moran and Klobuchar, as well as the other 17 original cosponsors.

Congress extends direct supervision enforcement moratorium. HR 4067, introduced by Congresswoman Jenkins (R-KS) passed both the House and Senate and now awaits the President’s signature.  It is anticipated that the President will sign.  The bill will extend to all of calendar year 2014 the enforcement moratorium on the outpatient therapeutic services “direct supervision” policy for critical access hospitals and rural prospective payment system hospitals with 100 or fewer beds.

NRHA and AHA send joint letter to Congress commemorating Rural Health Day. NRHA and the American Hospital Association teamed together to send a letter to the House Rural Health Coalition and the Senate Rural Health Caucus outlining the importance of Rural Health Day.  This event, we believe, exemplifies a new commitment on behalf of each association to work together toward to betterment of all rural hospitals.

NRHA is thankful for our rural champions and our NRHA members who support rural health care. But our work is not over yet. During December and the next year, NRHA will continue its efforts to protect the rural health safety net. NRHA asks you to continue the fight the 26th Annual Rural Health Policy Institute Feb. 3-5 in Washington, D.C. Click here to register today.