Bills would boost rural health care
Would help elderly, uninsured children
By Kathy Helms
Diné Bureau
WINDOW ROCK U.S. Sen. Pete Domenici has joined members of
the Rural Health Caucus to introduce a wide-ranging rural health
care bill that would improve Medicare and Medicaid payments to physicians
who treat seniors in rural, under-served areas.
Domenici, primary co-sponsor of the bipartisan Craig Thomas Rural
Hospital and Provider EquityAct of 2007, joined Sens. Kent Conrad,
D-N.D., Tom Harkin, D-Iowa, and Pat Roberts, R-Kan., on Wednesday
to introduce the bill, which was renamed in honor of the late Sen.
Craig Thomas, R-Wyo., who last week died of cancer.
The bill takes several steps to shore up health care in rural states
like New Mexico, including an extension of expiring rural health
provisions from the Medicare Modernization Act of 2003, the prescription
drug benefits law.
Overall, the R-HoPE Act would extend benefits to all of New Mexico's
27 rural hospitals that serve a disproportionate share of low-income
Medicaid recipients.
It would reinstate the "hold harmless" provisions for
small rural hospitals with fewer than 100 beds, provide aid to low-volume
rural hospitals, and expand the Medicare reimbursement eligibility
to mental health care providers in rural areas, including marriage
counselors and family therapists.
It also would extend provisions included in the MMA to put rural
physicians more on par with urban doctors in terms of Medicare reimbursement
levels by extending the Physician Fee Schedule Work Geographic Adjustment
provisions ( set to expire at the end of the year through Jan. 1,
2010.
Preliminary estimates indicate that the financial impact on New
Mexico's rural facilities could result in as much as a 15 percent
increase in Medicare revenues, according to Domenici.
"New Mexico is among large rural states that are consistently
challenged to provide health care to their citizens. The state's
economic condition has improved, but that does not diminish hardships
faced by small town hospitals and clinics in attracting and retaining
physicians and health care workers," he said.
Medicare bases physician payments, in part, on geographic adjustment
factors. The geographic index is designed to reflect relative cost
differences in a given area compared to the national average. Payments
to physicians in rural areas are adjusted downward by the index,
thus lowering reimbursements to rural caregivers.
"In addition, there are many areas where rural hospitals and
clinics need special attention because they cannot realistically
keep pace with health care demands and rising costs," he said.
The bill would increase the all-inclusive payment rate cap for rural
health clinics from $63 to $92 per patient to more appropriately
cover service costs.
On Thursday, Domenici, U.S. Sens. Jeff Bingaman, D-N.M., and Maria
Cantwell, D-Wash., led a bipartisan effort to correct an inequity
in the State Children's Health Insurance Program law that prevents
New Mexico from covering thousands of low-income children.
The senators, as well as governors from 11 affected states, including
New Mexico Gov. Bill Richardson, are urging the Senate Finance Committee
to support the proposal and implement a permanent fix to the problem.
"The law locks out states that demonstrated leadership on expanding
poor children's insurance coverage early on, and as a consequence,
New Mexico is being denied access to much of the allotted funding,"
Domenici said.
According to Bingaman, New Mexico has one of the highest uninsured
rates in the country and is struggling to find adequate health care
resources.
"The current SCHIP law is not working for New Mexico and it
must be fixed," he said. Bingaman serves on the Senate Finance
Committee that is expected to consider a new SCHIP bill in the coming
weeks.
Through SCHIP, created in 1997, states were granted federal funds
to expand coverage to low-income children who did not qualify for
Medicaid but whose families could not afford health insurance. However,
the law penalizes states like New Mexico that already had expanded
health care coverage to many low-income children before 1997, by
prohibiting them from coverage under SCHIP. As a result, New Mexico
has been forced to return more than $165 million to the federal
government since 1998, and could stand to forfeit another $11.9
million this year.
"In our state, this important program helped us to provide
health insurance to more than 15,000 children and low-income adults,"
said Gov Richardson. "This program will also help us expand
health care coverage to an additional 18,000 low income adults this
year."
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Friday
June 15, 2007
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