S. 2284Senate108th Congress (2003-2005)In Committee

Medicare Rural Community Hospital Demonstration Project Expansion Act of 2004

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2 earlier actions

SenateIntro Referral Latest Action

Read twice and referred to the Committee on Finance.

Finance Committee

April 6, 2004

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SenateIntro Referral

Introduced in Senate

April 6, 2004

SenateIntro Referral

Sponsor introductory remarks on measure. (CR S3792-3793)

April 6, 2004

SenateIntro Referral

Read twice and referred to the Committee on Finance.

Finance Committee

April 6, 2004

Floor Debate

3 members

What members said about S. 2284 on the floor

2 Republicans1 Democrat

Sen. Orrin G. HatchR-UT · Apr 6, 2004

Mr. President, I rise today to introduce a bill that would direct the Secretary of the Interior to convey a parcel of property to Beaver County, UT. This bill would allow Beaver County in…

Mr. President, I rise today to introduce a bill that would direct the Secretary of the Interior to convey a parcel of property to Beaver County, UT. This bill would allow Beaver County in Southwestern Utah to obtain and maintain, without restrictions, the former Minersville State Park. In sum, this bill is necessary to allow County officials to sell a small portion of this land--which has essentially been under their control for over 40 years--in order to offset funding needed to maintain the remainder of the park.

Some history might be beneficial at this point. In 1961, Beaver County obtained a lease for 207 acres of land from the Bureau of Land Management (BLM) to develop a recreational locale under the Recreation and Public Purposes Act. In 1963, Beaver County turned over the acreage to the State for the development of a park. Over the course of nearly 40 years, the State of Utah spent about one million dollars to develop campsites, a boat ramp, a dock, and other camping amenities to turn this area into the Minersville Reservoir State Park. In 2002, in an endeavor to reduce operating costs, Utah State Parks transferred control of the area back over to Beaver County. As County officials stated during negotiations, in order for Beaver County to afford management of the day to day operations of the would-be county park, they would need to sell some of the property to private investors. However, it was not until after park management responsibility was transferred to the county that the BLM pointed out that the state had not yet acquired the property through the Recreation and Public Purposes Act process. The plan for Beaver County to sell some of the land to pay for park operation, however, is not allowed under the Recreation and Public Purposes Act lease, which only allows the property to be developed for recreation or other purposes. The only way for Beaver County to undertake responsibility for park is to remove the current Federal restrictions on the property.

Today, Beaver County faces financial constraints in operating this park that threaten its continued use. Due to the prevailing restrictions in the Recreation and Public Purposes Act lease, initiated more than 40 years ago, the good people of southern Utah and visitors to the area will not be able to access and enjoy this county park. The campsites would be littered and unkept. The boat ramp and the boat docks would have to be closed. The park would become a destitute recreation area, because there would be no one to administer park maintenance and upkeep. The only public access to Minersville Reservoir, which features a converted blue ribbon trout fishery, would go to waste because of the Federal government's current Recreation and Public Purposes Act lease restriction.

I don't believe that letting management of the park revert to the BLM is a viable option either. The intensive, day to day management this small park requires can be best accomplished to local officials. If Beaver County acquires the property, it will continue to make this park an excellent recreational refuge, a superb fishery, and a great place to visit. Beaver County will be able to provide a clean and safe park enjoyed by all who visit. That is why I am introducing this legislation this legislation that would convey the Minersville Park land to Beaver County.

I thank the Senate for the opportunity to address this issue today, and I urge my colleagues to support this legislation.

Sen. Ben NelsonD-NE · Apr 6, 2004

Mr. President, today I introduce legislation to continue the relief to six hospitals in Nebraska that have been struggling financially under the current Medicare payment structure. Local hospitals…

Mr. President, today I introduce legislation to continue the relief to six hospitals in Nebraska that have been struggling financially under the current Medicare payment structure.

Local hospitals can best meet the unique needs of rural communities which is why I am committed to ensuring that these hospitals have the resources they need. Vital services like hospitals are increasingly important for the survival of our rural communities. Towns can't adequately serve residents--or attract new residents--without access to basic services. We need to focus on ensuring that hospitals and other vital services have the resources they need, so that communities will have the essential services they require.

Last year, Senator Brownback and I proposed legislation to provide cost-based reimbursement for rural community hospitals. Rural Community Hospitals (RCH) are hospitals with between 25-50 beds. Those hospitals had been adversely affected by Medicare formulas that set rates for reimbursement nationwide. These rates did not take into account the higher costs of practicing medicine in rural areas as these areas do not have the benefits of volume that larger hospitals enjoy. RCHs are also too large to qualify for critical access designation given to hospitals with fewer than 25 beds.

I am pleased that provisions from this legislation were included in the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 as a pilot program. The program provided cost-based reimbursements for inpatient services.

The legislation Senator Brownback and I are introducing today will expand the pilot program to cover outpatient services as well. This legislation will again address a critical shortcoming in current reimbursement practices and help Rural Community Hospitals serve their communities and invest in the future of rural health care.

Six Nebraska hospitals would be affected by expanding the scope of the pilot program. Those hospitals are: Beatrice Community Hospital, Columbus Community Hospital, McCook Community Hospital, Jennie Melham Memorial Medical Center in Broken Bow, Phelps Memorial Health Center in Holdrege, and Tri County Hospital in Lexington.

We made some progress for our rural hospitals by creating the RCH pilot program last year. This legislation would expand on that victory by ensuring that all Medicare treatments, whether inpatient or outpatient, would receive cost-based reimbursement. Expanding this program will make a big difference to these hospitals and more importantly, the patients they serve.

Sen. Ben NelsonD-NE · Apr 6, 2004

Mr. President, today I introduce legislation to continue the relief to six hospitals in Nebraska that have been struggling financially under the current Medicare payment structure. Local hospitals…

Mr. President, today I introduce legislation to continue the relief to six hospitals in Nebraska that have been struggling financially under the current Medicare payment structure.

Sen. Jeff SessionsR-AL · Apr 6, 2004

Mr. President, I ask unanimous consent that the text of the bill be printed in the Record.

Bill Text

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Introduced in SenateIssued April 6, 2004

        [Congressional Bills 108th Congress]
[From the U.S. Government Publishing Office]
[S. 2284 Introduced in Senate (IS)]

108th CONGRESS
2d Session
S. 2284

To expand the medicare rural community hospital demonstration program
to include outpatient services.

_______________________________________________________________________

IN THE SENATE OF THE UNITED STATES

April 6, 2004

Mr. Nelson of Nebraska (for himself and Mr. Brownback) introduced the
following bill; which was read twice and referred to the Committee on
Finance

_______________________________________________________________________

A BILL

To expand the medicare rural community hospital demonstration program
to include outpatient services.

Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

This Act may be cited as the ``Medicare Rural Community Hospital
Demonstration Project Expansion Act of 2004''.

SEC. 2. EXPANSION OF THE MEDICARE COMMUNITY HOSPITAL DEMONSTRATION
PROGRAM.

(a) Expansion.--
(1) In general.--Section 410A(a)(1) of the Medicare
Prescription Drug, Improvement, and Modernization Act of 2003
(Public Law 108-173) is amended by inserting ``covered
outpatient hospital services (as defined in subsection
(f)(3))'' after ``subsection (f)(2))''.
(2) Payment.--Section 410A(b) of the Medicare Prescription
Drug, Improvement, and Modernization Act of 2003 (Public Law
108-173) is amended--
(A) in paragraph (1), in the heading, by striking
``In general'' and inserting ``Covered inpatient
hospital services''; and
(B) by adding at the end the following new
paragraph:
``(3) Covered outpatient hospital services.--The amount of
payment under the demonstration program for covered outpatient
hospital services furnished in a rural community hospital is,
at the election of the hospital in the application referred to
in subsection (a)(3)--
``(A) the reasonable costs of providing such
services, without regard to the amount of the customary
or other charge and any limitation under section
1861(v)(1)(U) of the Social Security Act (42 U.S.C.
1395x(v)(1)(U)); or
``(B) the amount of payment that would otherwise be
provided for such services under the prospective
payment system for hospital outpatient department
services under section 1833(t) of such Act (42 U.S.C.
1395l(t)).
``(4) Beneficiary cost-sharing for covered outpatient
hospital services.--The amount of beneficiary cost-sharing for
covered outpatient hospital services furnished in a rural
community hospital under the demonstration program shall be the
amount determined under section 1833(t) of the Social Security
Act (42 U.S.C. 1395l(t)), without regard to any payment under
paragraph (3)(A) of this subsection.''.
(3) Funding.--Section 410A(c)(1) of the Medicare
Prescription Drug, Improvement, and Modernization Act of 2003
(Public Law 108-173) is amended by inserting ``and the Federal
Supplementary Insurance Trust Fund established under section
1841 of such Act (42 U.S.C. 1395t), in such proportion as the
Secretary determines to be appropriate,'' after ``(42 U.S.C.
1395i)''.
(4) Definition.--Section 410A(f) of the Medicare
Prescription Drug, Improvement, and Modernization Act of 2003
(Public Law 108-173) is amended by adding at the end the
following new paragraph:
``(3) Covered outpatient hospital services.--The term
``covered outpatient hospital services'' has the meaning given
the term ``covered OPD services'' in section 1833(t)(1)(B) of
the Social Security Act (42 U.S.C. 1395l(t)(1)(B)).''.
(b) Effective Date.--The amendments made by this section shall take
effect as if included in the enactment of section 410A of the Medicare
Prescription Drug, Improvement, and Modernization Act of 2003 (Public
Law 108-173).
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