Bill would require Department of Health and Human Services to conduct an evaluation of Medicare reimbursement rates between urban and rural hospitals and make appropriate adjustments
WASHINGTON – Congressman Fred Keller (R-PA) on Thursday introduced the Reviewing Urban and Rural Adjustments to Level Hospital Expenses and Lopsided Payments Act of 2020, otherwise known as the RURAL HELP Act with original co-sponsors Congressman GT Thompson (R-PA), Congressman Mike Kelly (R-PA), Congressman Jim Hagedorn (R-MN), and Congressman Rick Crawford (R-AR).
The legislation aims to bring parity to inpatient Medicare reimbursement payments between rural and urban hospitals to help struggling rural hospitals survive by requiring the U.S. Department of Health and Human Services to determine the precise level of systematic disparity that exists between urban and rural hospital payments under such reimbursements. It also specifies that once the evaluation is completed, the Secretary shall make an adjustment to Centers for Medicare and Medicaid Services payment policies to make up for the identified disparity.
According to the National Rural Health Association, over just the last ten years, 124 rural hospitals have closed with another 453 at risk for closure.
As it relates to Pennsylvania’s 12th Congressional District, the RURAL HELP Act will help keep the following hospitals open by providing reimbursement parity with urban or suburban hospitals:
- Evangelical Community Hospital in Lewisburg, Union County
- Williamsport Regional Medical Center in Williamsport, Lycoming County
- Geisinger-Lewistown Hospital in Lewistown, Mifflin County
- Lock Haven Hospital in Lock Haven, Clinton County
- Robert Packer Hospital in Sayre, Bradford County
- Mount Nittany Medical Center in State College, Centre County
On the introduction of the RURAL HELP Act, Congressman Fred Keller (R-PA) made the following statement:
“Visiting with rural hospitals across Pennsylvania’s 12th Congressional District, it is clear they provide a vitally-needed service to a unique community. However, these hospitals consistently face the risk of closure from things like lopsided Medicare reimbursement rates, particularly are they cater to an aging population reliant on government-managed healthcare plans.
“Given the critical nature of rural hospitals to a vulnerable community, and the ability to undertake this review in the short-term, re-evaluating these rates to provide parity with urban hospital settings is the step needed right now to ensure healthcare availability drops off the list of concerns for rural Americans.”
In addition, the following groups made statements in support of the RURAL HELP Act.
Background:
Earlier this year, Congressman Keller led a letter to CMS Administrator Seema Verma asking her agency to re-evaluate the Medicare Severity Diagnosis Related Group (MS-DRG) classification system in the annually updated Medicare Inpatient Prospective Payment System (IPPS)—the mechanism that determines Medicare reimbursement for inpatient services at most hospitals.
The MS-DRG recalibrations have negatively impacted these types of rural hospitals over the last several years and this re-evaluation is a critical component to ensuring rural hospitals receive the appropriate Medicare reimbursement amount.
