House Members Lobby for Rural Health Care Legislation

Six members of the House Rural Health Care Coalition on Thursday lobbied for newly introduced legislation (HR 5118) that would extend six provisions of the 2003 Medicare law aimed at improving access to health care in rural areas that are set to expire this year, CQ HealthBeat reports.

According to CQ HealthBeat, the provisions include:

• A 5% payment adjustment for home health services in rural areas;
  
• A "hold harmless" provision for outpatient treatment provided by sole community hospitals in rural areas to ensure payment levels; an incentive payment for physicians practicing in "physician scarcity areas";
  
• A 2% reimbursement bonus for ambulance trips in rural areas;
  
• A guaranteed minimum reimbursement rate for rural doctors; and
  
• A "reasonable cost payment" for lab tests performed for outpatient services in rural hospitals.

Rep. Greg Walden (R-Ore.), co-chair of the coalition and the bill's sponsor, said, "Ensuring these payments is critical to maintaining care and access to rural medical services," adding that while the bill would cost about $3.1 billion over five years, it ultimately would save the Medicare program money.

Rep. John Peterson (R-Pa.), a member of the coalition and a co-sponsor of the bill, said if Congress does not extend the provisions, "it costs everybody more, and people will die."

Representatives from medical and health care organizations said that doctors who want to work in rural areas would have a hard time doing so without the reauthorization of the provisions in the legislation.

Tom Nickels, senior vice president for federal relations at the American Hospital Association, said, "The work that a physician does does not vary by location, but the payment does" (George, CQ HealthBeat, 4/27).

In related news, the St. Petersburg Times on Friday examined the Medicare Rural Hospital Flexibility Program and the requirements that facilities must meet in order to qualify as a critical access hospital. According to the Times, the program enables certain small hospitals to receive Medicare reimbursements that are almost equal to full cost, "unlike other hospitals that must accept whatever Medicare decides to pay."

Hospitals in every state except Rhode Island, New Jersey, Delaware, Connecticut and Maryland participate in the program. According to the Times, the program "was created to help rural hospitals regain their financial footing," but "it could be in jeopardy because President Bush wants to eliminate federal funding for grants next year" (St. Petersburg Times, 4/28).