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Senate delivers rural hospital and VA victories, but punts SGR

Among the amendments passed to the Senate Budget Resolution (S. Con. Res. 11) early Friday, was the National Rural Health Association-supported amendment No. 356 to allow the VA to provide veterans access to non-VA health care services when the nearest VA medical facility within 40 miles from a veteran’s home is unable to offer appropriate care for the veteran. The amendment, which passed 100-0, was authored by Sen. Jerry Moran (R-Kan.) and allows rural veterans to have quality, timely care in their rural communities. The budget also included language to make permanent the Medicare-dependent hospital (MDH) program and the low-volume hospital (LVH) adjustments. The House passed its own budget this week, and the two versions will need to be reconciled. NRHA is also pleased with this week’s passage of the Medicare Access and CHIP Reauthorization Act in the House, which was the first step to ensuring the seamless continuation of multiple programs of importance to rural America. The bill provides for a repeal of the flawed physician Medicare payment formula known as the Sustainable Growth Rate (SGR) and replaces it with a payment system that promotes a higher quality of care. Of particular importance to rural America, the bill also includes a two-year extension of the LVH, MDH, work geographic index floor under the Medicare physician fee schedule, current rural and super-rural ambulance add-on payments, an exceptions process for Medicare therapy caps, community health centers, National Health Service Corps teaching health centers, and the Children’s Health Insurance Program (CHIP). The Senate did not vote on the Medicare and CHIP Reauthorization Act before leaving for recess, but is expected to take action upon returning to Washington.  NRHA is disappointed with the Senate’s decision to punt the SGR vote and leave physicians facing a 21 percent cut in Medicare reimbursements at the end of the month. According to the Centers for Medicare and Medicaid Services, “services rendered on or before March 31, 2015, are unaffected by the payment cut and will be processed and paid under normal procedures and time frames.” NRHA urges Congress to ensure these cuts do not take effect. NRHA will continue to advocate strong funding for the rural health safety net. Members of Congress just began a two-week recess, and the timing is crucial. Your elected officials must hear from you in support of critical rural health programs. Contact your senators and representatives today to set up a visit and invite them to your facility. Speak up at a town hall meeting, and let them know how vital these programs are to your facility and your community. And register today to learn more about emerging issues in rural Medicare policy at NRHA’s 38th Annual Rural Health Conference in Philadelphia.

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