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Senators
approve higher Medicare rates for rural hospitals By
Jack Sullivan WASHINGTON
- Senators
approved a measure Thursday that would provide rural and urban hospitals
with similar payments from Medicare, the federal health care program for
seniors. "This
gives substantial momentum to this effort to begin to level the playing
field between rural hospitals and more urban institutions," said Sen.
Kent Conrad, D-N.D. The
payments have been based on the belief that it is cheaper to treat people
in small towns. Many
lawmakers and hospital administrators say that premise is no longer true.
Hospitals everywhere, they argue, vie for the same doctors and nurses when
hiring and pay the same for supplies and equipment - even though rural
hospitals have fewer patients and less income. "Health
care providers and hospitals in rural areas should not be penalized for
doing more with less," Finance Committee Chairman Charles Grassley,
R-Iowa, said Thursday. Congress
equalized the payments for the current year. The amendment approved
Thursday would extend the fix and raise rural Medicare payments for other
services, including ambulance services and home-health care providers. The
payments could mean the difference between survival and failure for some
hospitals, said Sen. Tim Johnson, D-S.D. "If
rural providers can't get proper reimbursement, they will eventually be
forced to turn patients away or shut their doors altogether," Johnson
said. Provisions
are similar to those in bills introduced last month in both the House and
Senate. Conrad,
D-N.D., introduced the earlier Senate bill, which applied only to
hospitals, with Sen. Craig Thomas, R-Wyo., and others. Conrad
said he was concerned that they would be paid for in part through offsets
that would reduce Medicare payments for some cancer treatments. He
said Grassley has agreed lawmakers need to find other sources for those
funds when lawmakers reconcile the bill with tax legislation already
passed by the House. If
the provisions become law: _
payments between rural and city hospitals would be made equal; _
the effect regional labor costs have on Medicare payments would be
lessened; and _
the smallest hospitals would get more money. Conrad
said Grassley's support as chairman of the Senate Finance Committee, and
the fact Congress approved a temporary fix to the rural rates, makes him
optimistic the measure will survive negotiations with House lawmakers. Sen.
Max Baucus, D-Mont., expects to be a negotiator and will defend the
provisions. According
to Senate Finance Committee staffers, the hospital provisions would send
$107 million to Montana; $100 million to South Dakota; $73 million to
North Dakota; and $56 million to Wyoming. Payments
to doctors also would go up by 12 percent in South Dakota; 10 percent in
Montana and North Dakota; and 7 percent in Wyoming. Thomas
said current provisions force some doctors to limit how many Medicare
patients they serve, while the amendment "ensures adequate payments
so our doctors can continue to care for seniors." Copyright © 2002 Global
Action on Aging |
