Maggie Elehwany, NRHA's vice president for government affairs and policy, spoke with me this week to detail the Senate action, provide some context, prognosticate on the chances that the rural health amendments will survive the budget negotiations early next year, and describe other challenges that rural health faces at the Capitol. The following is an edited transcript.
HLM: Can you give us a sense of how rural healthcare is faring under these various budget bills?
Elehwany: On the Senate side are many important rural healthcare provisions that have long tracked with the SGR. The biggest was the critical access hospital program and others that were temporary were the Medicare dependent hospital program and the low-volume hospital adjustment. Those were extended every time we put the patch on the SGR. But they did expire last Oct. 1 at the end of the fiscal year.
That is why we felt it was so important for Congress to extend those. Not only did the Senate extend the payments but they made them permanent for the low-volume hospital adjustment. The initial Senate Finance Committee mark made the payments permanent but they did modify and cut the reimbursement levels. Senators (Charles) Schumer, (D-NY), and (Chuck) Grassley, (R-IA), restored the payments in full and made them permanent. So, we couldn't be happier.
HLM: Will these amendments pass in the final budget resolution?
Elehwany: This is a big step, an important step but certainly only one step in a long process. The Senate included the important rural amendments, but the House did not include them at all. The House knew the doc fix was going to happen sooner and they did a three-month patch on all of these provisions.