Mr. President. Today, I introduce legislation that will overturn a new regulation that is putting critical access hospitals (CAH) at risk by arbitrarily lowering the Medicare reimbursement for laboratory services. Sixty rural hospitals in…
Mr. President. Today, I introduce legislation that will overturn a new regulation that is putting critical access hospitals (CAH) at risk by arbitrarily lowering the Medicare reimbursement for laboratory services. Sixty rural hospitals in Nebraska will be negatively impacted unless this regulation is reversed.
This legislation would repeal a Center for Medicare and Medicaid Services' (CMS) regulation that would prohibit critical access hospitals from being reimbursed at-cost for laboratory services, unless patients are ``physically present in a critical access hospital'' when laboratory specimens are collected. Many CAHs provide laboratory services in rural health clinics (RHCs) and nursing homes in smaller, neighboring communities, as well as in home-health settings; however, the elimination of cost-based reimbursement may make it prohibitive for them to continue offering off-site laboratory testing. In short, under the new regulation, lab services would not be reimbursed by CMS unless the patient is at the facility where testing will occur.
This change jeopardizes rural Americans' access to care by imposing an additional burden on the frail elderly by requiring them to visit the hospital to get simple lab tests done. The additional time and expense incurred by the patient is unnecessary if the CAR is willing and able to conduct tests at the point of patient care and transport it back to the hospital for analysis.
Congress created the CAR program in 1997 to ensure that those in isolated, rural communities have access to health care. To protect the viability of these hospitals, often a community's only source of vital health care services, Congress established cost-based reimbursement for Medicare inpatient and outpatient services--regardless of where the services are provided. The new regulation would fundamentally alter this well-established practice.
We have tried to work with CMS to change the rule. In November of 2003, I was joined by 28 Senators in a bipartisan letter to the Administrator of CMS asking for his assistance in constructing a rule that does not penalize CAHs for offering off-site laboratory services. Unfortunately, CMS responded that the rule would stay intact.
I am pleased to be joined in this effort by Senator Susan Collins. Senator Collins has been a strong advocate for rural health care, and I look forward to working together on this legislation.
The Nebraska critical access hospitals affected by the regulation are:
Harlan County Health System in Alma
Fillmore County Hospital in Geneva
Pawnee County Memorial Hospital in Pawnee City
Niobrara Valley Hospital Corporation in Lynch
Thayer County Health Services in Hebron
Kimball County Hospital in Kimball
Kearney County Health Services/Hospital in Minden
Saunders County Health Services in Wahoo
Henderson Health Care Services in Henderson
Community Memorial Hospital in Syracuse
Garden County Hospital & Nursing Home in Oshkosh
Franklin County Memorial Hospital in Franklin
Genoa Community Hospital in Genoa
Gothenburg Memorial Hospital in Gothenburg
Annie Jeffrey Memorial County Health Center in Osceola
Brodstone Memorial Nuckolls County Hospital in Superior
Webster County Community Hospital in Red Cloud
Tilden Community Hospital in Tilden
Morrill County Community Hospital in Bridgeport
Jefferson Community Health Center in Fairbury
Memorial Hospital in Aurora
Oakland Memorial Hospital in Oakland
St. Francis Memorial Hospital in West Point
Alegent Health Memorial Hospital in Schuyler
Nemaha County Hospital in Auburn
Brown County Hospital in Ainsworth
Antelope Memorial Hospital in Neligh
Cozad Community Hospital in Cozad
Litzenberg Memorial County Hospital in Central City
Avera St. Anthony's Hospital in O'Neill
Warren Memorial Hospital in Friend
Creighton Area Health Services in Creighton
Butler County Health Care Center in David City
Rock County Hospital in Bassett
Boone County Health Center in Albion
Callaway District Hospital in Callaway
York General Hospital in York
Howard County Community Hospital in St. Paul
Memorial Hospital CAH in Seward
Dundy County Hospital in Benkelman
Chadron Community Hospital Health Services in Chadron
St. Mary's Hospital in Nebraska City
West Holt Memorial Hospital in Atkinson
Cherry County Hospital in Valentine
Providence Medical Center in Wayne
Plainview Public Hospital in Plainview
Osmond General Hospital in Osmond
Tri Valley Health System in Cambridge
Pender Community Hospital in Pender
Johnson County Hospital in Tecumseh
Chase County Community Hospital in Imperial
Community Medical Center in Falls City
Valley County Hospital in Ord
Crete Area Medical Center in Crete
Ogallala Community Hospital in Ogallala
Perkins County Health Services in Grant
Memorial Health Center in Sidney
Gordon Memorial Hospital District in Gordon
Memorial Community Hospital in Blair
Box Butte General Hospital in Alliance