RURAL CLINICS: Senators Propose Safety Net
Sens. Max Baucus (D-MT) and Charles Grassley (R-IA) introduced legislation Thursday that they said would head off a potential funding shortfall at community health centers and rural clinics when certain provisions of the Balanced Budget Act of 1997 take effect Oct. 1, the Billings Gazette reports. Under the budget act, the government will phase out cost-based reimbursement for the clinics and rural health centers, leaving community centers to "subsidize [their] Medicaid patients with grant funds received for programs for indigent people," said Yellowstone City-County Health Department's Lil Anderson (Bellinghausen, Billings Gazette, 6/25). In introducing their Safety Net Preservation Act of 1999, the senators said they would establish a prospective payment system to ensure that health centers receive sufficient Medicaid funding and can avoid dipping into their indigent care reserves. "These rural health clinics cannot afford to lose Medicaid funding," Baucus said, noting that many "administrators fear that this cut, coming on top of many other reductions, could jeopardize the services they provide." Nationwide, the community clinics stand to lose $1.1 billion over five years, according to the National Association of Community Health Centers, Inc. "These clinics are often the difference between seeing a doctor and forgoing treatment," Grassley, said, adding, "We can't allow money shortfalls to force them to shut down" (Grassley/Baucus release, 6/24). Although the senators' "safety net" scheme is not as generous as the "reasonable cost" system currently in place, "it would offer better reimbursement than the centers could expect under the regular Medicaid payment system," the Billings Gazette reports. The prospective payment system would be updated each year to keep pace with the types of services and the clientele of each clinic (6/25). The set reimbursement rate "will safeguard the congressional investment in community health centers as the providers of only resort for millions of Americans and will ensure that health centers remain strong, vital, and able to serve their communities for years to come," said Ann Peters, chair of the National Association of Community Health Centers' board of directors (NACHC release, 6/24).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.