NRHA works to achieve historic rural spending in Stimulus Bill
Earlier today, the Senate voted to approve their version of the stimulus package by a vote of 61-37. The NRHA has worked to advance numerous provisions for the betterment of rural health care in both the Senate and House stimulus bills. Funding included in the House and Senate bills compute to the greatest dollars amounts invested in rural health care and infrastructure in the nation's history.
We are happy to report that the Senate version includes the following investments in rural health:
Significant investments in health information technology (HIT) -
- $31 billion in total Medicare and Medicaid payments:
- For physicians and health professionals - Medicare incentive payments for rural providers that meaningfully adopt electronic health records (EHR) of up to 100% of the Medicare portion of the cost of EHR starting in 2011 (urban providers can receive up to 75%). These eligible professionals can receive up to $41,000 per professional. In leiu of the Medicare incentives, these professionals that see over 30% of their patients from Medicaid can receive 85% of their allowable cost on the Medicaid side up to an amount of $75,000 with annual limits. After 2015, eligible providers receive a penalty on Medicare payments if they do not adopt.
- For Critical Access Hospitals - Medicare incentive payments to CAHs that meaningfully adopt HIT systems at $1.5 million each. In addition, the CAH is still able to depreciate the cost of the HIT system on their cost report. If a CAH doesn't meaningfully adopt HIT by 2015, they begin receiving smaller payments, down to 100% of cost from Medicare starting in 2017.
- For rural PPS Hospitals - Medicare incentive payments to rural PPS hospitals that meaningfully adopt HIT systems will be based on a formula. That formula gives each hospital a base $2 million amount and then adds additional payments per each discharge up to 23,000. After 2015, if the hospital has not meaningfully adopted HIT, they will begin to receive a penalty on their Medicare payments.
- For Rural Health Clinics and Federally Qualified Health Centers - Medicaid incentive payments of at least 85% of the Medicaid cost of HIT systems for those facilities that have at least 30% of their patients on Medicaid, mirroring the eligible providers payments under the Medicaid system.
- For Indian Health Services facilities - $85 million for HIT systems.
- $3 billion to the Office of the National Coordinator of HIT to make sure that providers, especially in underserved communities, have money to invest and implement HIT in their facilities
Temporary investment in the Medicaid system - $87 billion
- This will assure that states have the money they need to maintain their current Medicaid rolls and not simply cut reimbursement rates to providers
- In addition, it allows states the option of covering recently unemployed workers through their Medicaid program
Investments in health care facilities of interest to rural populations
- $1.37 billion for Veterans' Administration health facilities
- $1.87 billion for Section 330 grantees, such as Community Health Centers
- $410 million for Indian Health Services health facilities
- $127 million for rural community facility development, which translates into about $50 million in grants and $1.171 billion in direct loans and $325 million in guaranteed loans for rural facilities, including health care facilities
Investments in the rural broadband network
- At least $3.5 billion for rural broadband implementation programs (half of the overall pot) to develop the next generation broadband networks in rural America
Additional rural health investments:
- $100 million for distance learning and telemedicine
- Significant advancements in Water and Waste Disposal Program that improve the public health
The Senate bill will now be combined with the House bill, which had previously passed by a vote of 244 to 188, in a process called conference. We will be working with champions in both the House and Senate to assure that the final bill that passes is supportive of the rural health system. That includes working to include money from the House that would have improved health workforce issues. A one-page document for members of Congress is available.
We will keep you posted throughout the process and will need your help to ask your members of Congress to support the package.
