Terri Sewell introduces two bills to improve rural access to health care
Democrat and Alabama 7th District U.S. Rep. Terri Sewell reached across the aisle last week to her Republican colleague Nebraska 3rd District U.S. Rep. Adrian Smith to introduce two bills to improve rural access to health care. H.R. 1041: the Critical Access Hospital Relief Act H.R. 1041 will repeal Medicare’s 96-hour rule, which requires physicians to certify at the time of admission their intent to discharge or transfer the patient to another hospital within four days. Many deem this an “arbitrary” requirement that risks depriving patients in rural areas of the critical care necessary to save lives, which is why the Centers for Medicare and Medicaid Services (CMS) has addressed the 96-hour rule through rule-making, but H.R. 1041 would codify it into law and ensure the issue is address permanently. “We know that access to good primary care results in people living longer, healthier lives, but in many communities across the country, including many in Alabama’s 7th District, medical professional shortages threaten access to quality health care,” Sewell explained. “Our Medicare payment policies must eliminate barriers that stand in the way of our ability to attract qualified medical talent to rural and underserved areas, such as physician assistants.” Sewell continued, “Every American should be able to receive the care they need, regardless of where they live, but the 96-hour rule disproportionately threatens access to health care for Americans living in rural areas, like my constituents serviced by Choctaw General Critical Access Hospital, and severely affects Critical Access Hospitals’ ability to operate.” H.R. 1052: the Physician Assistant Direct Payment Act H.R. 1052 will allow physician assistants to be directly compensated by Medicare in order to expand their role as medical providers in underserved communities. At present, physician assistants are the only providers allowed to bill Medicare for services rendered, but required to have their payments routed through a third party such as a physician or hospital. “Rural Americans are frequently left out of the debate in Washington and it’s imperative we continue to fight for their best interests,” Smith added. “The repeal of Medicare’s 96-hour rule and allowing physician assistants to be paid directly by Medicare are two great examples of ensuring rural Americans receive better care.” Rural hospitals close in Alabama Sewell introduced her bill just days before news broke that the Georgiana Medical Center in Georgiana, Ala. will be closing on March 31 due to the rising costs of health care. It will be the state’s 13th hospital to close in eight years, and the seventh rural hospital among those to close. According to Danne Howard, Policy Director at the Alabama Hospitals Association, about 88 percent of the state’s rural hospitals are operating “in the red” and aren’t currently receiving reimbursements that can cover the cost of delivering care.
Terri Sewell introduces bill to allow direct Medicare payments to physician assistants
Given the shortage of physicians and the ever increasing demand for medical services, many physicians depend heavily on physician assistants (PAs) to provide care within their practice. But PAs across the country are running into a problem: they are the only Medicare-eligible health professionals not paid directly by Medicare for the services they provide. Which is why Alabama-Democrat, 7th District U.S. Rep. Terri Sewell reached across the aisle to Nebraska-Republican, 3rd District U.S. Rep. Adrian Smith to propose a solution. Their answer: H.R. 5506: the Physician Assistant Direct Payment Act. The bill would amend title XVIII of the Social Security Act to provide for direct payment to physician assistants under the Medicare program for certain services furnished by such physician assistants. “In many communities across the country, including many in my district, medical professional shortages threaten healthcare access and quality. We know that there is tremendous need for more primary care providers in rural areas today and that this need will only grow during the next decade,” explained Sewell. “Our Medicare payment policies must eliminate any barriers that stand in the way of our ability to attract qualified medical talent to rural and underserved areas, including both physician and non-physician providers, such as physician assistants.” Sewell believes H.R. 5506 is a “step forward” in Congress’ overall work to improve access to quality healthcare in rural areas. Smith agrees. “Rural communities, like many in Nebraska’s Third District, continue to lack the variety of healthcare options afforded to other areas of the country,” added Smith. “This narrowly-targeted, bipartisan solution repeals a burdensome regulation which disincentivizes the hiring of physician assistants. At present, Medicare payments to PAs must pass through a third party medical practice, which is an unnecessary and bureaucratic step. This bill will improve access to care in rural communities without impacting the scope of practice, education, or licensing requirements for PAs.” H.R. 5506 has been referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means.
