At a press conference Thursday on Capitol Hill, Reps. Greg Walden (R-OR) and Earl Pomeroy (D-ND), co-chairs of the 182-member House Rural Health Care Coalition, announced the introduction of legislation to help ensure rural America continues to have access to quality health care despite the often higher costs of health care delivery in rural and isolated communities in Oregon and throughout the nation.

The Medicare Rural Health Provider Payment Extension Act, H.R. 5118, would extend Medicare reimbursement methods for services provided in isolated or underserved areas to help ensure that such reimbursements are equitable and fair for costs incurred by rural health providers. 

"Rural communities, including those in central, southern and eastern Oregon, face unique issues and challenges when it comes to health care delivery and accessibility. Often, isolated areas face higher costs for medical services given greater distances between patients and care facilities or a lack of physicians or facilities serving a given area. H.R. 5118 would help ensure that Oregonians-especially the elderly and disabled-have access to quality, affordable health care through reasonable and equitable reimbursement rates for rural health providers," said Walden. 

H.R. 5118 was introduced by Walden on April 6 and now has more than 50 bipartisan cosponsors. The bill has also earned early support from the National Rural Health Association (NRHA), American Hospital Association, National Association for Home Care and Hospice (NAHC) and American Osteopathic Association. The NRHA named Walden its 2005 legislator of the year for his commitment to rural health care issues and the NAHC named Walden its 2004 "Home Care Hero" for his advocacy on behalf of home health. 

Provisions in the Medicare Rural Health Provider Payment Extension Act would: 

- Extend the 5% payment adjustment for home health services provided in rural areas to help offset higher home health delivery costs, which can be as much as 12- to 15-percent higher than in urban areas. There are 22 home health providers in Walden's district, which help ensure access to home care for residents in central, southern and eastern Oregon. However, higher costs threaten the ability of these providers to remain in business. This payment adjustment would allow these providers to keep providing critical home care services to patients in remote or isolated areas;

- Extend the Medicare incentive payment program for physicians practicing in designated physician scarcity areas, rural communities and counties recognized as having a low number of physicians serving a given population. In the Second District, there are eight counties with seven or fewer physicians, two of which have none at all;

- Extend the 2% bonus payment for ambulance trips in rural areas to help offset the higher costs of ambulance services in rural areas, which contain farther distances between patients and care facilities. In Oregon, ambulance service providers are, on average, reimbursed for only 70% of costs incurred for emergency medical and transport services for Medicare beneficiaries, which account for a vast majority of their business. This discrepancy and the rising costs of gasoline (gas is estimated to be 22% higher in rural areas) could lead to greatly reduced ambulance services in rural communities;

- Extend the 1.0 floor on Medicare reimbursements to rural areas to ensure fair and reasonable repayment to facilities and care providers in rural areas. Providers in rural areas are often reimbursed at a rate lower than 1.0, thus receiving less than actual costs incurred, for services provided to Medicare beneficiaries, unjustly penalizing them based on geographic location;

- Extend the hold harmless treatment for the nation's 535 sole community hospitals (SCH), which provide inpatient health services for residents in rural, isolated communities, to ensure equitable reimbursements for services provided. In the Second District, SCHs currently operate in Bend, Klamath Falls and The Dalles. Hermiston's Good Shepherd Medical center recently reduced patient services to achieve a classification other than a SCH, becoming eligible for more fair reimbursements rates; and,

- Extend reasonable cost reimbursement for clinical lab tests performed by rural hospitals as part of their outpatient services (i.e. for area patients receiving care at home or in nursing homes). Oftentimes, a local rural hospital is the only lab facility serving a given region, and although lab work conducted for patients in the hospital or in a local nursing home is the same, hospitals are reimbursed at a lower rate for clinical lab work for patients that do not have specimens drawn in the hospital. This drives up the overall cost of lab work for patients in the region and could lead to greater inaccessibility for lab work conducted for home bound patients or those who live far from the actual hospital.

"The Medicare Modernization Act took great strides to support rural health care providers, yet we recognize that many of those protections are expiring," said Bill Sexton, President of the NRHA and Chief Executive of the Providence North Coast Service Area. "NRHA fully supports Congressman Walden's efforts to extend the MMA's important investments in rural health care, and believes this legislation will assist rural providers in their ongoing efforts to provide medical care for those in need." 

"I appreciate the strong, bipartisan support shown for this important legislation by members of the Rural Health Care Coalition from all corners of our great nation, and I look forward to working with Mr. Pomeroy and our cosponsors as we work to advance H.R. 5118 through the Congress," added Walden. More information on the bill can be found at http://thomas.loc.gov. 

Congressman Walden represents Oregon's 2nd District, which includes 20 counties in central, southern and eastern Oregon. He is co-chair of the bipartisan Rural Health Care Coalition. Before his election to Congress, Walden spent several years as a member of the board of trustees of Hood River Memorial Hospital.