NRHA Critical Rural Medicare Extenders that must Continue
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Transcript of NRHA Critical Rural Medicare Extenders that must Continue
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7/30/2019 NRHA Critical Rural Medicare Extenders that must Continue
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NationalRuralHealthAssociationandPolicyPartners:AgriSafeNetwork,NationalAssociationofRuralHealthClinics,NationalCooperativeofHealthNetworks,NationalOrganizationofStateOfficesofRuralHealth,NationalRuralRecruitmentandRetentionNetwork,NationalAssociationforRuralMentalHealth
CriticalRuralMedicareExtenders
MustContinueFightingforRuralTogether
TheNationalRuralHealthAssociationandpolicypartnersaskCongresstoprotectthefragileruralhealthcare
deliverysystembyextendingcriticalruralhealthprovisionsthataresettoexpireatvariouspointsin2012.These
provisionshavelongreceivedbipartisansupportandmustbeextendedinanylegislationaimedatupdatingthe
sustainablegrowthrate(SGR)orotherexpiringtaxprovisions.
Theseprovisionsinclude:
MedicareDependantHospital(MDH)Classification.Aruralhospitalunder100bedsmusthaveatleast60percent
ofitsdaysordischargescoveredbyMedicarePartA.Thedesignationspaymentmethodology,establishedinthe
early1990s,protectshospitalswithhighMedicaresharefromlossesincurredunderthePPSsystem. MDH
classificationpaymentsarescheduledtoexpirefordischargesoccurringonorafterOctober1,2012.
OutpatientHoldHarmlessProvision.ExtendtheexistingoutpatientholdharmlessprovisionandwouldallowSole
CommunityHospitalswithmorethan100bedstoalsobeeligibletoreceivethisadjustment. Theholdharmless
provisionissettoexpireonFebruary29,2012.
LowVolumeHospitalAdjustment.Anumberoflowvolumehospitalscurrentlyreceiveapercentageaddon
paymentforeachoftheirMedicaredischarges.Toqualifyfortheadjustmentahospitalmustbe15roadmilesfrom
anotherhospitalandhavelessthan1,600dischargesduringthefiscalyear.Thisadjustmentappliestofacilities
operatinginthePPSsystem.ThisprovisionissettoexpireonSeptember31,2012.
Section508Hospitals.Certainhospitals,identifiedinSection508oftheMedicareModernizationAct,areallowed
topetition
the
Centers
for
Medicare
and
Medicaid
Services
to
reclassify
their
wage
index
market
to
more
accuratelyreflectthelabormarketinwhichtheyparticipatebasedontheirphysicallocation. Thisallowanceisset
toexpireonFebruary29,2012.
FairPhysicianPayments.Thisprovisionmodifiesthegeographicindexfloor.Thisfloorappliesanadjustmentto
theworkportionofthephysicianfeeschedulethroughFebruary29,2012,withtheeffectofincreasingpractitioner
feesinruralareas.
RuralAmbulanceProvision.ThisprovisionextendsamodifiedpaymentstructuremadebyMedicareforground
andairambulanceservicesinruralandotherareas. ThesepaymentsaresettoexpireonFebruary29,2012.
MentalHealth
Provisions
of
the
Physician
Fee
Schedule.
This
payment
increases
the
assigned
Physician
Fee
Schedulerateforpsychiatricservicesdeliveredbyphysicians,clinicalpsychologistsandclinicalsocialworkers. This
5percentpaymentincreaseissettoexpireonFebruary29,2012.
RuralMedicareLaboratoryPayments.ReinstatesandextendsthepolicyincludedintheMedicareModernization
Actof2003thatprovidesreasonablecostreimbursementforlaboratoryservicesprovidedbycertainsmallrural
hospitals. ThispaymentmethodologyissettoexpireonFebruary29,2012.
