Rural Health Care Bill Cosponsored by Senator Domenici

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Office of Senator Domenici

13 June 2007

The Bill Offers Added Payments for Rural Hospitals, Other Care Providers

WASHINGTON:

U.S. Senator Pete Domenici today again joined fellow members of the Rural Health Caucus to introduce a wide-ranging rural health care bill that includes provisions he has championed to improve Medicare and Medicaid payments to physicians who treat seniors in rural, under-served areas. Domenici is an original cosponsor to the bipartisan Craig Thomas Rural Hospital and Provider Equity (R-HoPE) Act of 2007 (S.1605), which was introduced Wednesday by Senators Kent Conrad (D-N.D.), Tom Harkin (D-Iowa), and Pat Roberts (R-Kan.). They, like Domenici, are all Senate Rural Health Caucus members.

The bill will be renamed in honor of the late Senator Craig Thomas (R-Wyo.), a previous sponsor of similar legislation who last week died of cancer. This bill, a Rural Health Caucus effort, takes several steps to shore up health care in rural states like New Mexico and includes a number of provisions supported by Domenici in the past.

It would extend expiring rural health provisions from the Medicare Modernization Act (MMA) of 2003, the prescription drug benefits law. "New Mexico is among large rural states that are consistently challenged to provide health care to their citizens. The states’ economic condition has improved, but that does not diminish hardships faced by small town hospitals and clinics in attracting and retaining physicians and health care workers,” Domenici said. “In addition, there are many areas where rural hospitals and clinics need special attention because they cannot realistically keep pace with health care demands and rising costs,” he said.

Included in the R-HoPE Act is an extension of provisions—included in the MMA that Domenici first authored and offered as legislation in February 2003—to put rural physicians more on par with urban doctors in terms of Medicare reimbursement levels.

The R-HoPE Act would extend these Physician Fee Schedule Work Geographic Adjustment provisions through Jan. 1, 2010. They are set to expire at the end of this year. Medicare bases physician payments, in part, on geographic adjustment factors.

The purpose of the geographic index is to reflect relative cost differences in a given area compared to the national average. Payments to physicians in rural areas are adjusted downward by this geographic index, thus lowering the reimbursements to rural caregivers. Domenici also pointed out that the bill contains a provision to benefit community health care centers and rural health clinics, which play an important role in health care delivery for many low-income and rural New Mexicans.

The bill increases the all-inclusive payment rate cap for rural health clinics from $63 to $92 per patient to more appropriately cover service costs. Overall, the R-HoPE Act would extend benefits to all of New Mexico’s 27 rural hospitals that serve a disproportionate share (DSH) of low-income Medicaid recipients and rural hospitals.

It would, for instance, reinstate the “hold harmless” provisions for small rural hospitals with fewer than 100 beds. It would also provide aid to low-volume rural hospitals, as well as expand Medicare reimbursement eligibility to mental health care providers in rural areas, including marriage and family therapists. Preliminary estimates demonstrate that if all the provisions in the Act were to be enacted the financial impact on New Mexico’s rural facilities could result in as much as a 15 percent increase in Medicare revenues.