Bill to protect rural health services passes Senate, expected to pass House

A federal bill that passed the Senate last week and is expected to pass the House could cut down on long drives for rural patients and ease concerns for understaffed rural hospitals. The bill creates a one-year enforcement delay on legislation passed in 2009—that was only enforced last year—which required a doctor to be present in any department where Medicaid and Medicare patients were receiving outpatient therapeutic services—drug infusions, blood transfusions, outpatient psychiatric services, wound debridement and cardiac and pulmonary rehabilitation services.

The ruling is good news to many rural hospitals like Lincoln Hospital (right) in Davenport, Wash., where 70 percent of the patients on are Medicare or Medicaid, Matt Kalish reports for The Spokesman-Review. The hospital "doesn’t typically have physicians in the building unless a procedure or appointment is scheduled. The emergency department at Lincoln is staffed by nurses, and an on-call doctor is summoned when needed." Hospital administrator Tom Martin told Kalish, “You’re wearing people out. Now they’re having to come in for a procedure (when) they didn’t have to be here before. It’s a perspective that’s coming out of an urban center; they’re not understanding how we operate in rural communities.”

Mo Sheldon, CEO of Odessa Memorial Healthcare Center in Odessa, Wash., said "Repealing the rule gives rural hospitals needed flexibility. The current policy could force patients to drive long distances for care if a doctor is not available," Kalish writes. She told Kalish, “Rural hospitals have been providing these services with quality and efficiency. Our communities risk losing needed services due to the potential increased cost associated with implementing a direct supervision policy.” (Read more)

Sen. Jerry Moran

The bill was introduced by Sen. Jerry Moran (R-Kan.), who said the Centers for Medicare and Medicaid Services' "imposing such an unrealistic and clinically unnecessary supervision policy jeopardizes patients’ access to important therapy services in rural communities in Kansas and across the country,” reports the High Plains/Midwest Ag Journal. “This one-year enforcement delay is needed because many Kansas hospitals are considering cutting services for their patients or limiting hours of operation in order to comply with this inflexible regulation. Congress needs to direct CMS to implement a reasonable policy that more adequately reflects the realities of providing care in rural areas.” (Read more)