Author Archives: Erin Mahn

Appropriations season in full swing

The Fiscal Year 2016 appropriations are underway.

The Senate Appropriations Subcommittee will markup FY 2016 Labor, Health and Human Services Funding Bill, which includes funding for multiple important rural health programs, at 3 p.m. ET today. To listen live, click here.

Tomorrow the full House Appropriations Committee will markup the bill. The House report is here.

NRHA continued to support robust funding for the rural health safety net in the FY 2016 funding measures.

Stay tuned to NRHA’s blog for the latest appropriation news.

NRHA asks Congress to support Border Health Security Act

The National Rural Health Association (NRHA) urges members of Congress to support the Border Health Security Act introduced by Senators Tom Udall (D-NM) and Martin Heinrich (D-NM). NRHA believes Congress must continue to make investments in emergency preparedness, health surveillance, and rural community infrastructure, particularly, at our nation’s borders.

The United States-Mexico Border Health Commission has worked over the past decade to address major bi-national health issues that strain the public health systems of both nation’s along the shared border. A major focus is on communicable diseases, such as H1N1, hepatitis, and measles, since these diseases do not recognize nor respect borders. As the Commission enters its second decade, the focus must be broadened and strengthened to improve defenses against bioterrorism, to warn of communicable disease outbreaks, and address the many health disparities in the border region.

The legislation would reauthorize the Early Warning Infectious Disease Surveillance (EWIDS) program. Created in 2003, it provide states along the U.S.-Mexico and U.S.-Canada borders with funding to detect, identify, and report outbreaks of infectious diseases. The bill also authorizes $7 million per year for border grants and operations.

The House companion bill will be introduced by Rep. Rubén Hinojosa (D-TX).

House Appropriations Committee markups FY 2016 Labor, Health and Human Services Funding Bill

The House Committee on Appropriations will mark up today the Fiscal Year 2016 Labor, Health and Human Services Funding Bill, which includes funding for health programs through the Department of Health and Human Services.

The total package is about $14.55 billion or a 9 percent cut from the President’s budget request for health, labor and education appropriations for FY 2016.

The bill includes $71.3 billion for HHS funding, which is an increase of $298 million above last year’s level and $3.9 below the President’s request. Funding for the Health Resources and Service Administration (HRSA) is $6 billion, which is $299 million below last year’s level and $413 million below the President’s request.

The bill does not include the President’s cuts to Critical Access Hospitals.

Watch the markup live here.

Stay tuned to NRHA’s blog for the latest appropriation news.

NRHA speaks at Rural Health 101 for senators

Maggie Elehwany, National Rural Health Association vice president of government affairs, discussed the importance of rural health care today during a Rural Health 101 policy briefing on Capitol Hill.

Elehwany spoke on the significant role rural providers play to the older, sicker, and poorer population they serve.

“Sixty-two million patients rely on rural providers,” Elehwany said. “These providers are facing unprecedented challenges from Washington, from challenges in Medicaid expansion, continued cuts in Medicare and continued threats of additional Medicare cuts.”

Elehwany urged the Senate to protect access to care for these vulnerable populations, and to save the 283 rural hospitals that are on the brink of closure. Already 53 rural hospitals have closed since 2010. Without congressional intervention, layoffs, wage cuts, economic loss, reduced services and closed doors will occur in more rural communities across America.

“If Congress doesn’t act to stop the bleeding and prevent further closures of rural hospitals, 700,000 patients would lose timely access to care,” Elehwany cautioned. “Patients and local economies in your state will suffer.”

In addition to NRHA, representatives from the Office of Rural Health Policy, National Association of Rural Health Clinics and the American Hospital Association participated in the Rural Health 101 briefing, sponsored by the Senate Rural Health Caucus. The caucus is chaired by Sens. Pat Roberts (R-KS) and Al Franken (D-MN).

NRHA encourages senators to join the caucus and its members to ask their elected officials to #SaveRural hospitals and patients today.

Join the walk to save rural hospitals

Fifty-three rural hospitals have closed; 283 more are on the brink of closure.

Since January 2013, more rural hospitals have closed than in the previous 10 years combined.

It’s clear continued cuts in hospital payments have taken their toll, forcing closures and leaving many of our nation’s most vulnerable populations without timely access to care.

Led by Mayor Adam O’Neal, a group of advocates from 14 states are walking 283 miles – one for each at-risk hospital – from rural Belhaven, N.C., and arriving at 11 a.m. June 15 at the U.S. Capitol to draw attention to the dire situation rural hospitals and communities are facing.

If Congress doesn’t act to stop the bleeding and prevent further closures of rural hospitals, 700,000 patients would lose direct access to care; patients and local economies will suffer.

Without congressional intervention, layoffs, reduced wages, economic loss, reduced services, or worse, closed doors will occur in more rural communities across America.

The National Rural Health Association invites you to the conclusion of The Walk for Rural Hospitals at 11 a.m. June 15 on the east grounds of the Capitol, between the Capitol building and the Supreme Court building. This is a free event and all are encouraged to attend to show their support for rural hospitals.

If you are unable to attend, join NRHA’s Virtual March for Rural Hospitals on June 15. Call, email, Tweet and Facebook your members of Congress, and ask them to protect rural hospitals and patients.

Be sure to also:

• Attend town halls. Be prepared to ask questions and share your stories about rural hospitals.

• Write a letter or op-ed to your local media.

• Invite your members of Congress and health legislative assistants to tour your facility.

• Hold a press conference about what these programs mean to your hospital and town.

For more information and ways to #SaveRural hospitals and patients, visit NRHA’s Save Rural Hospitals Action Kit.


Contact your Senate Finance Committee member now to support amendments

This morning, the Senate Finance Committee will markup Chairman Orrin Hatch’s (R-UT) Audit & Appeal Fairness, Integrity, and Reforms on Medicare Act of 2015 which includes several changes to how Medicare contractors will review providers’ Medicare claims.

NRHA is urging you to call your Senators on the Finance Committee now and urge them to support three amendments to the mark:

– Cardin Amendment – “Improving Accuracy and Transparency of Federal Reporting of Recovery Auditor Auditing and Appeals”

– Heller Amendment – Section 12 “Availability of Medical Records Based on Accuracy”

– Stabenow Amendment – Section 12 “Strike Contractor Document Collection Language”

Continue monitoring our blog for the latest government affairs news.

Conrad State 30 & Physician Access Act introduced in Senate

The National Rural Health Association applauds the introduction of the bipartisan S.1189, the Conrad State 30 & Physician Access Act introduced by Sens. Jerry Moran (R-KS), Susan Collins (R-ME) and Heidi Heitkamp (D-ND).

This legislation will improve and make permanent the Conrad State 30 program, also known as the J-1 Visa Waiver program. This program was enacted in 1994 as a national initiative that permits states to recommend visa waivers for physicians recruited to care for patients in rural and underserved areas. The Conrad State 30 & Physician Access Act removes the sunset of the program, improves its functioning, and allows it to expand its scope to better meet the needs of rural America.

NRHA supports this legislation, which makes great strides in the recruitment of physicians to rural areas and the delivery of vital health care services in rural America. The Conrad State 30 program will help hospitals, clinics and group practices increase access to health care in rural America.

NRHA’s Rural Health Congress approves new policies

The Rural Health Congress recently approved five new policy papers.

The National Rural Health Association’s policy-making body, the Rural Health Congress, determines the association’s positions on public policy through a series of policy briefs and issue papers. The congress consists of elected representatives from each of the association’s constituency groups and councils as well as Board of Trustees officers.

The Comprehensive Quality Improvement in Rural Health Care policy paper is an update of the 2007 paper. It updates the definition of quality of care with a renewed focus that emphasizes patient and family engagement, care coordination, and population health. NRHA can play an essential role to ensure that local, state and federal partnerships are strong, committed and aligned to support comprehensive quality improvement strategies and infrastructure needed to promote continuous quality improvement in rural health care.

The Designation of Frontier Health Professional Shortage Areas policy paper demonstrates that the additional resources available to communities federally designated as Health Professional Shortage Areas (HPSA) are critical to allow safety net providers, including those serving populations in frontier areas, to serve their patients with adequate support staff, up-to-date equipment, and appropriate medications. The HPSA criteria currently in place does not ensure access to federal resources in areas with sparse or geographically isolated populations, which often experience the greatest challenges to recruiting health care professionals. The paper recommends the HPSA criteria take into account the unique characteristics and challenges of sparsely populated and geographically isolated areas. A separate designation of frontier HPSA would address many of these issues.

The Future of Rural Behavioral Health policy paper outlines the limits rural residents have in accessing behavioral health care. Attracting, broadening and training the workforce, addressing reimbursement and financing issues with appropriate compensation for professional behavioral health care providers and affordable options for patients, fostering the integration of health care services with care coordination and referral networks, being mindful of the changing cultural landscape in rural areas, and utilizing tele-behavioral health will all play essential roles in reducing health disparities in rural communities. Leadership is critically needed to advance comprehensive policies at every level that ensure the availability, accessibility, affordability and acceptability of quality behavioral health services for rural Americans.

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Senators, NRHA members speak against CAH cuts in president’s budget

Senators and testifying witnesses expressed concerned over the proposed cuts to critical access hospitals (CAHs) in the president’s budget, during today’s Senate Appropriations Subcommittee on Labor, Health and Human Services, Education, and Related Agencies hearing on rural health programs in the Health and Human Services fiscal year 2016 budget,

The budget calls for reducing reimbursement for all CAHs from 101 percent of “reasonable costs” to 100 percent of reasonable costs and eliminating the critical access designation for hospitals closer than 10 miles to the nearest hospital, regardless of community need, the type of facility less than 10 miles away, or the reason a governor designated the hospital as a necessary provider.

“I am concerned that some of the proposals within the department’s budget and recent regulations that have been issued would disproportionately affect rural health care and jeopardize health care access – and threaten the survival of small towns,” Chairman Roy Blunt (R-MO) said.

Sen. Jerry Moran (K-RS) raised many critical questions about the CAH program and effects such cuts would have on the rural health safety net. Moran quoted the National Rural Health Association in his exchange with Tom Morris, Federal Office of Rural Health Policy associate administrator, about the accelerated pace at which rural hospitals have been closing. Moran asked Morris for a report of not only what happens to a community when a hospital closes, but also what steps could have been taken to prevent the closure in the first place.

Morris said the department was going to continue to further study rural hospital closures. He said there isn’t a single factor behind the increase in closures, and it is very community specific.

“This is a real priority for us and we are going to work with colleagues across the department,” Morris added.

Several NRHA members testified before the committee today on the importance of rural programs and how cuts and regulations are burdening their facilities, including George Stover, CEO of Rice County Hospital District 1 in Lyons, Kan., and Tim Wolters, who serves as the director or reimbursement at Citizens Memorial Hospital and the reimbursement specialist for Lake Regional Hospital System in Missouri.

Stover said steps should be taken to minimize the regulatory burdens placed on rural health providers, adding that CAH reimbursement reductions and sequestration cuts would potentially exacerbate rural hospitals’ challenges.

Wolters also outlined challenges to rural hospitals, including patient volumes, Medicare utilization, the cumulative impact of Medicare reimbursement cuts and the increasingly complex regulatory environment.

NRHA applauds the witnesses and senators for supporting the rural health care safety net.

NRHA asks Congress to protect the funding these important rural programs receive, to protect the CAH designation and to protect the nearly 300 rural hospitals on the brink of closure.

NRHA supports reintroduction of Hospital Payment Fairness Act

The National Rural Health Association is pleased Sen. Claire McCaskill (D-MO) is reintroducing the Hospital Payment Fairness Act with Sen. Richard Burr (R-NC) as a push to repeal the piece of the Affordable Care Act that has resulted in a wage increase for all Massachusetts hospital physicians and staff at the detriment of rural hospitals across the nation.

The provision required 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 Affordable Care Act establishes a pool of money for which hospital wages can be reimbursed via Medicare. Because of this, an increase for one state decreases the funds available for other states.

NRHA supported this legislation when it was previously introduced and will support it again.