Sen. Pat Roberts introduced a bill Monday in the U.S. Senate that would change a Medicare rule for small, rural hospitals.
The bill – the Critical Access Hospital Relief Act of 2014 – would remove the condition that requires physicians to certify that a patient is expected to be discharged or transferred to a different hospital in less than 96 hours in order to receive payment from Medicare.
“We need to focus on ensuring rural patients have access to their health systems, not come up with bureaucratic ways to make it harder for patients in rural areas to get quality care from their doctors,” said Roberts, who sits on the Senate’s Finance and Health committees and is the co-chairman of the rural health caucus.
Kansas has 83 critical access hospitals – more than any other state.
The designation is for smaller, rural hospitals that receive a bump in Medicare reimbursements to help ensure access to health care.
Roberts said there are disparities and misconceptions about funding challenges between urban and rural health care systems and that rural health care programs have been “targeted again and again” by the federal government.
He called the current rules harmful because they force doctors into guessing games about patients, and that could lead to patients being discharged prematurely and to re-admissions.
Tom Bell, president and CEO of the Topeka-based Kansas Hospital Association, said his group hopes Roberts’ colleagues in the Senate will support the legislation.
The 96-hour rule is just one of increasing regulatory burdens for hospitals, Bell said.
“This rule is part of (Medicare’s) attempt to regulate more admissions and timing of admissions,” Bell said.
“We’ve had many of our members tell us it really makes very little sense.”
Critical access hospitals have to meet special requirements from Medicare to qualify for higher reimbursement rates.
Some of those requirements include being located in a rural area; providing emergency services 24 hours a day, seven days a week; having no more than 25 inpatients beds; and maintaining an average annual length of stay of 96 hours or less per patient, among others.
The Senate bill has 13 co-sponsors from both parties.
The legislation was also introduced in the House earlier this month by Rep. Adrian Smith, R-Neb., and co-sponsored by Kansas Rep. Lynn Jenkins, R-Topeka. That bill was referred to the House Ways and Means Committee.