Final Agreement on Rural Medicare Provisions Reached

By: Alan Morgan | 2/16/12

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Rural Victories Several critical rural Medicare provisions are included in a bill to be voted on by Congress as early as Friday. Many of these provisions were seriously threatened in recent months but, because of your advocacy and persistence, NRHA was successful in making sure a number of these provisions were included in the final package, which temporarily addresses a number of tax and Medicare provisions. Of particular importance, a ten-month extension of the outpatient hold-harmless provision to hospitals with less than 100 beds was included in the final compromise after being excluded in prior versions of the legislation.  If these hospitals were to lose hold harmless payments, their losses would prove catastrophic a number of hospitals currently participating in the program would have negative margins exceeding 50% while others would have negative margins exceeding 25%. Congress provides this outpatient payment because if these hospitals were to fail, residents of the communities they serve would be without hospital services. Other provisions that were included in the package include:

• Ten-month extension of the current geographic practice cost index
• Ten-month update of the sustainable growth rate (SGR)
• Ten-month extension of the current payment levels for rural ambulance providers
• Four-month extension of current “508 Hospital” wage index reclassification
• Four-month extension of the current technical component for pathology lab services

The Fight Continues While the inclusion of these provisions was a significant victory, some provisions which NRHA has long fought for were not included.  Specifically, the current payment increase for mental health providers was not included in the package and is set to expire on February 29.  Other provisions, which do not immediately expire, but will expire at various points in 2012, were also excluded in this deal including:

• Medicare Dependant Hospital classification (Expires October 1, 2012)
• The current Low-Volume Hospital adjuster (Expires September 30, 2012)
• Authorizing for funding the Rural Hospital Flexibility Program (Expires Sept. 30, 2012)
• Reasonable cost lab payments (Expires July 1, 2012)

NRHA continues to fight for the permanent codification of all these provisions and will continue to work to make sure these provisions are included in future legislation. Continued vigilance and advocacy by rural health advocates remains critical.  We encourage all those interested in rural health care to make your voice heard by calling your Senator or House Member today and asking for the FULL inclusion of all these provisions.