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Senators, NRHA members speak against CAH cuts in president’s budget

Senators and testifying witnesses expressed concerned over the proposed cuts to critical access hospitals (CAHs) in the president’s budget, during today’s Senate Appropriations Subcommittee on Labor, Health and Human Services, Education, and Related Agencies hearing on rural health programs in the Health and Human Services fiscal year 2016 budget, The budget calls for reducing reimbursement for all CAHs from 101 percent of “reasonable costs” to 100 percent of reasonable costs and eliminating the critical access designation for hospitals closer than 10 miles to the nearest hospital, regardless of community need, the type of facility less than 10 miles away, or the reason a governor designated the hospital as a necessary provider. “I am concerned that some of the proposals within the department’s budget and recent regulations that have been issued would disproportionately affect rural health care and jeopardize health care access – and threaten the survival of small towns,” Chairman Roy Blunt (R-MO) said. Sen. Jerry Moran (K-RS) raised many critical questions about the CAH program and effects such cuts would have on the rural health safety net. Moran quoted the National Rural Health Association in his exchange with Tom Morris, Federal Office of Rural Health Policy associate administrator, about the accelerated pace at which rural hospitals have been closing. Moran asked Morris for a report of not only what happens to a community when a hospital closes, but also what steps could have been taken to prevent the closure in the first place. Morris said the department was going to continue to further study rural hospital closures. He said there isn't a single factor behind the increase in closures, and it is very community specific. “This is a real priority for us and we are going to work with colleagues across the department,” Morris added. Several NRHA members testified before the committee today on the importance of rural programs and how cuts and regulations are burdening their facilities, including George Stover, CEO of Rice County Hospital District 1 in Lyons, Kan., and Tim Wolters, who serves as the director or reimbursement at Citizens Memorial Hospital and the reimbursement specialist for Lake Regional Hospital System in Missouri. Stover said steps should be taken to minimize the regulatory burdens placed on rural health providers, adding that CAH reimbursement reductions and sequestration cuts would potentially exacerbate rural hospitals’ challenges. Wolters also outlined challenges to rural hospitals, including patient volumes, Medicare utilization, the cumulative impact of Medicare reimbursement cuts and the increasingly complex regulatory environment. NRHA applauds the witnesses and senators for supporting the rural health care safety net. NRHA asks Congress to protect the funding these important rural programs receive, to protect the CAH designation and to protect the nearly 300 rural hospitals on the brink of closure.

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