Sen. Chuck Grassley (R-Iowa) has introduced legislation intended to improve Medicare payments to rural doctors, ambulance services and midsized hospitals. The Medicare Rural Health Access Improvement Act of 2009 would also seek to protect access for rural residents to home medical equipment and supplies, as well as continue to lend support to critical-access hospitals, according to a summary of the legislation from Grassleys office.
In addition, the bill could provide relief to the so-called tweener hospitals, which are too large to be designated as critical-access hospitalshaving 25 or fewer bedsbut too small to be financially viable under the Medicare hospital prospective payment system. Grassley said in a news release that there is no justification for Medicare not to recognize the unique role of these facilities.
Most tweener hospitals are designated in the Medicare program as Medicare Dependent Hospitals or Sole Community Hospitals. Specifically, this bills provisions would provide temporary and permanent improvements so that payments to these hospitals would better reflect the cost of providing inpatient and outpatient services. Also, the bill would extend and increase rural ambulance payments by 5% for next year. And it would protect rural areas from being affected by the new Medicare competitive-bidding program for durable medical equipment, as rural and metropolitan statistical areas with populations of 600,000 or fewer would be exempt from the bidding process. (For more on this topic, please see Snapshot of the tween scene.)