McMorris Rodgers, Kind Introduce Bill to Ensure Rural Hospitals Receive Medicare Reimbursements

(Washington, D.C.)  Representatives Cathy McMorris Rodgers (R-WA) and Ron Kind (D-WI) today introduced H.R. 2159 The Rural Health Services Preservation Act of 2007. This legislation supports Critical Access Hospitals in rural areas by ensuring that they receive proper reimbursement for care provided to patients enrolled in the Medicare Advantage (MA) program.

“There are 18 Critical Access Hospitals throughout Eastern Washington that provide vital health care services to people living in rural communities,” said McMorris Rodgers. “These rural hospitals have a higher percentage of Medicare patients and will be unable to continue to provide access to health care if they do not receive cost-based reimbursement. This bill will help ensure rural hospitals are reimbursed for care provided to seniors and prevent higher out-of-pocket costs for patients.”

"From life-threatening emergencies to preventive care, Critical Access Hospitals are often the sole health care provider to rural residents," said Kind, member of the House Ways and Means Health Subcommittee, which has jurisdiction over Medicare. "We must ensure that they can continue to provide these vital services to rural communities, and this bill will prevent Critical Access Hospitals from being short-changed by Medicare Advantage plans."

To account for unique challenges Critical Access Hospitals face as rural providers, these facilities are reimbursed by Medicare at 101 percent of cost for providing care to seniors. However, many Critical Access Hospitals do not receive cost-based reimbursement for providing care to seniors in the MA program. MA Plans are health plan options that are part of the Medicare program and often allow beneficiaries to receive additional benefits at lower premiums.

To correct this imbalance, the Rural Health Services Preservation Act would ensure that Critical Access Hospitals are reimbursed at the same levels by MA plans as they receive under Medicare. MA plans would be required to reimburse Critical Access Hospitals at either 101 percent of cost plus contract-end cost reconciliation, or at 103 percent of cost.

This bill is supported by the American Hospital Association, the National Rural Health Association and the Washington State Hospital Association.