Some Republican members of the House Rural Caucus said they will not sign Medicare reform legislation unless it includes provisions to assist rural providers. Arguing that Congress has always treated rural providers unfairly, Rep. John Peterson (R-Pa.) said any Medicare bill that doesn't increase rural hospital payments doesn't address the inequities making it difficult for rural providers to stay in business. The prescription drug bills now being crafted represent "our avenue to make certain rural healthcare is not ignored," said Rep. Jerry Moran (R-Kan.). Rural caucus members would like to see the Medicare reform bill enact provisions to better account for hospitals' labor costs, permanently equalize the base payment rate for rural and urban hospitals, extend cost-based reimbursement to hospitals with fewer than 50 beds, and remove the current cap on Medicare disproportionate-share payments to rural facilities. Rep. Tom Osborne (R-Neb.) also said he plans to reject any bill that doesn't include rural assistance, but Moran said he's "not ready to draw a line in the sand." At deadline, House leadership could not be reached for comment. On Thursday, the Senate Finance Committee will debate a Medicare reform bill that includes many of the provisions advocated by the rural caucus. -- by Jeff Tieman
Rural aid or no drug bill, some Republicans say
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