Government Affairs News
News
MedPAC announces plans for final ACA rural report (1/18/12)
The Affordable Care Act mandated that the Medicare Payment Advisory Commission (MedPAC) study various components of the rural health care delivery system. The Commission was asked to study access to services, quality of care, payment adequacy and rural payment adjustments. The Commission met on Jan. 13 and 14 to set guiding principles for their final report (due to Congress in June) and discuss payment adequacy. It is noteworthy that MedPAC does not currently plan to make any recommendations on the four study areas mandated by Congress.
You can find their presentation slides here. More information on the final report will be made available on this page when it is released.
Super Committee announces failure to reach agreement (11/21/11)
On Nov. 21, the Joint Select Committee on Deficit Reduction announced that it was unable to come to an agreement prior to the Nov. 23 statutory deadline for deficit reduction. Nov. 21 marked the deadline to have a proposal scored by Congressional Budget Office and available to the public under “sunlight provisions” allowing the public to read spending bills prior to congressional action.
NRHA fought hard to maintain the Critical Access Hospital, Medicare Dependant Hospital, and Sole Community Hospital designations from elimination or large-scale modification. Various proposals called for large modifications to these programs or even the elimination of the designations entirely. We now can be sure that all facilities currently participating in these programs will maintain their reimbursement structures. NRHA members were instrumental in fighting these modifications and their efforts have clearly been successful.
The failure to strike a deal, though, means that a “sequestration” will go into effect January 2013. Included in the sequestration is a 2 percent cut to Medicare for all providers. During the next year, NRHA will continue its efforts to reverse the across-the-board cuts to rural facilities. These cuts will have a disproportionate affect on fragile safety net facilities and should not be allowed. Federal Medicaid payments will not be affected in the sequestration.
Click here to find the Super Committee statement. Continue to monitor this blog for information relating to the ongoing deficit reduction negotiations and the FY 2012 appropriations process.
Craig Thomas Rural Hospital and Provider Equity Act introduced in Senate (10/12/11)
On Oct.11, Senators Kent Conrad (D-ND), Pat Roberts (R-KS), Tom Harkin (D-IA), and John Barrasso (R-WY) introduced Senate Bill 1680, the Craig Thomas Rural Hospital and Provider Equity Act of 2011. This bipartisan legislation includes provisions that would modify outpatient therapy supervision requirements, extends various rural Medicare payment provisions, allows for telehealth services across state lines, and provides long-term funding authorizations for state offices of rural health among many important provisions.
NRHA applauds Senators Conrad, Roberts, Harkin and Barrasso and strongly supports the passage of S. 1680.
Rural facilities targeted in deficit reduction plans (10/8/11)
The Budget Control Act of 2011 (BCA) calls for $1.2-$1.5 trillion reduction in federal expenditures over the next ten years. A “Super-Committee” has been formed and tasked with developing the policies that will produce these reductions. Rural hospitals have been targeted in various proposals to the Super-Committee and to Congress as a whole.
The specific payment reductions advocated by each proposal vary and a number of groups have put forward various ideas. Proposals include:
• The Congressional Budget Office (CBO): Eliminate alternative hospital designations Critical Access Hospital (CAH), Sole Community Hospital (SCH), and Medicare Dependent Hospital (MDH). This plan would reduce hospital payments by $3.8 billion in fiscal year (FY) 2012 increasing to $9.5 billion in reduced payments in FY 2021. Total cut to rural facilities over 10 years: $62.2 billion.
• President Obama: Starting in FY 2013, the President’s plan would end add-on payments for physicians and hospitals in frontier states, reduce CAH reimbursement to 100 percent of reasonable cost, and end CAH reimbursement for facilities located 10 miles or less from another hospital. Total cut to rural facilities over ten years: $6 billion.
• House Republican Leadership: While specifics of the proposal were not released, House Republican Leadership sought to cut $2 billion from frontier state add-on payments and $14 billion from rural hospital reimbursement structures. Total cut to rural facilities over 10 years: $16 billion.
• Ways and Means Democratic Staff: The Democratic Staff from the House Ways and Means Committee embraced the CBO recommendation. They erroneously argued that the elimination of these payment structures would be more equitable and in line with other payment reforms. Total cut to rural facilities over 10 years: $62.2 billion.
• Sequestration: If the Super-Committee fails to produce sufficient savings, Medicare reimbursements will be “sequestered”. An automatic cut of 2% will be instituted on all providers. Total cut to rural facilities over 10 years: $5.9 Billion.
Centers for Disease Control and Prevention Announce Community Transformation Grant Awards (9/28/11)
The Centers for Disease Control and Prevention (CDC) announced grantees of some funds in the “Community Transformation Grant” program earlier this week. A total of $103 million was given to 61 grantees including state, local, and tribal governments. Grantees are tasked with addressing 1) tobacco-free living; 2) active living and healthy eating; and 3) evidence-based quality clinical and other preventive services, specifically prevention and control of high blood pressure and high cholesterol in their communities.
A total of $900 million was authorized for the Community Transformation Grant program by the Affordable Care Act. This program is designed to build capacity for community prevention efforts and improve health and wellness capacities. Under statute, twenty percent of the Community Transformation Grant funds are to be allocated to rural and frontier areas.
Bipartisan bill introduced to preserve rural health access (2/2/12)
Today, Rep. Cathy McMorris Rodgers, R-Wash., and Rep. Mike Thompson, D-Calif., co-chairs of the Congressional Rural Health Coalition, introduced H.R. 3859, the Rural Hospital and Provider Equity (R-HOPE) Act of 2012. This bipartisan bill would help rural communities across America protect and expand access to quality health care. Click Congress Passes FY 2011 Funding Bill (4/15/11)
House Passes FY 2012 Budget Resolution (4/15/11)
CBO report threatens rural hospitals (3/17/11)
The Congressional Budget Office recently released a report detailing ways in which the federal spending deficit could be reduced. One of their options, 