Promoting Health in Rural Areas
The Senate version of its recently passed tax legislation bill would increase Medicare payments to rural hospitals and doctors by $25 billion over 10 years, while reducing fees paid for medical devices. In addition it would reduce the fee paid for chemotherapy drugs, while adding deductibles and co-payments for laboratory services.The Senate and House versions of the tax legislation will now go to a committee which will work on a compromise bill.
A bill was originally introduced in the Senate on May 6, 1999 to "expand access, increase choice and improve the quality of health care provided in rural America." Sen. Chuck Grassley (Rep.-Iowa), Sen., Max Baucus (Rep.-Montana) and Senate Minority Leader Tom Daschle developed the bill.
Recently legislation has been introduced that would increase Medicare payments to rural hospitals. The legislation would provide increased payments to the smallest of rural hospitals, namely those with fewer than 800 discharges per year.
About 22 million rural Americans live in areas that are considered Health Professional Shortage Areas. These are areas that are deemed to not have enough doctors to serve their community. Under the proposed Act communities could get assistance for up to 12 months in advance when they know that a doctor is going to resign or retire. The proposed Act also ensures that new Medicare reimbursement rules for medical residents, enacted as part of the Balanced Budget Act of 1997, do not discriminate against areas that train residents in rural health clinics or other settings outside a hospital.
The proposed Act would correct Medicare payment formulas that discriminate against rural areas. It would guarantee that Medicare +Choice plans in rural areas get the increased reimbursements promised in the Balanced Budget Act of 1997. It is intended to ensure that Medicare beneficiaries in rural areas have several choices and are not restricted to just one provider.
The promise of telemedicine would be extended to rural areas under the proposed Act, with all Medicare services being covered thereunder. Any health care practitioner could present a patient to a specialist on the other side of the video connection.
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By Allan Rubin
updated May 17, 2003
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