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SGR Repeal Bill Holds Extra Promise for Rural Hospitals

John Commins, for HealthLeaders Media, December 18, 2013

A raft of amendments to the Senate version of the bill to repeal the SGR should make life a lot easier for rural hospitals, says a National Rural Health Association official.

The move in Congress to repeal the much loathed sustainable growth rate funding formula for physicians got most of the attention from the healthcare sector in the past few weeks. That's understandable, especially when we remember that physicians were staring at a 24% cut in Medicare reimbursements on Jan. 1 if the SGR had actually kicked in.

Now it appears that rural healthcare advocates have more to cheer about.


See Also: SGR Bill's Payment Transparency Provision Elicits Concern


The Senate has included amendments in its version of the bill that should make life a lot easier for rural hospitals. The National Rural Health Association's blog, in a succinct breakdown of what's included in the Senate's version of the SGR Repeal and Medicare Beneficiary Access Improvement Act of 2013, tells us that:

  • Amendment 117 would return supervision requirements for outpatient therapy services furnished at Critical Access Hospitals back to "general supervision." This was the supervision level observed at nearly every CAH prior to 2009.
  • Amendment 121 would ensure that the new Alternative Payment Models do not interfere with or inhibit the development of telehealth technologies that are critical to the future of delivering care in rural America.
  • Amendment 18 would permanently extend, at current levels two crucial rural hospital payments, the Medicare Dependent Hospital program and Low Volume Hospital Adjustment.
  • Amendment 82 would set a permanent floor on the work component of the Geographic Practice Cost Index at its current level of 1.0 creating a stable and more equitable reimbursement rate for rural physicians.
  • Amendment 118 would establish demonstration project for tile-health remote patient monitoring services. This demonstration would help show the efficacy remote patient monitoring in keeping patients in their homes rather than in hospitals.
  • Amendment 90 was withdrawn by its sponsors after a number of Committee Members promised to petition CMS for regulatory relief from the certification requirement of physicians admitting patients to CAHs that the patient would be discharged or transferred within 96 hours.
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