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New England Rural Health News

Newsletter of the New England Rural Health RoundTable

Senators Submit Bill
for Rural Medicare Improvements
From the National Rural Health Association

With time rapidly running out for any Congressional action on Medicare this year, two rural Senators, Senator Max Baucus (D-MT) and Senator Charles Grassley (R-IA), introduced on October 1, 2002 their Medicare legislation for consideration by the Senate Finance Committee. The bill is titled "The Beneficiary Access to Care and Medicare Equity Act" of 2002," Senate Bill Number S.3018. It has been read the first and second times and has been placed on the Senate calendar under General Orders.

New England co-sponsors to date (as of Oct 15) include Senator Edward Kennedy (D-MA) and Senator James Jeffords (I-VT). Passage of these critical provisions is still needed and seen by many as essential to improving health care in rural communities. This bill, should it pass the Senate, allows the Senate to at least go to Conference with the House and the chance of a reconciliation package for the President to sign.

Among the key provisions of this legislation for rural providers are the following:

" Establishing flexibility for Critical Access Hospitals to have up to 25 acute care beds.
" Equalizing the Medicare standardized payment amount.
" Rural Hospital FLEX Program Reauthorization
" Reauthorization of the Small Hospital Improvement Program (SHIP Program)
" Adjusting the wage index.
" Enhancing Disproportionate Share Payments for rural hospitals.
" Temporarily increasing payments for rural hospitals under PPS outpatient services.
" Revising the payment disparities for rural physicians.
" Extending the rural adjuster for home health.
" Extending the outpatient PPS hold harmless for rural hospitals by one year to 2005.
" Increasing ground ambulance payments for rural by 5%.
" Establishing a rural capital infrastructure loan program.
" Establishing Periodic Interim Payments (PIP) for CAHs.
" Exempting Rural Health Clinics and Federally Qualified Health Centers from the nursing home SNF PPS.
" Providing Medicare payments to certain non-physician providers on call in CAH emergency rooms.

A copy of the full legislation can be obtained from and will soon be posted on the National Rural Health Association website at

Fall 2002 Newletter
Page 2
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