WASHINGTON — U.S. Sens. Pat Roberts, R-Kan., and Jon Tester, D-Mont., today introduced bipartisan legislation to protect rural Critical Access Hospitals and their patients by eliminating new “condition of payment” rules from the Centers for Medicare and Medicaid Services that require a physician to predict and limit a patients’ stay to within 96 hours. The bill has 13 cosponsors.
“This rule requires doctors to be clairvoyant and predict the unknown at the time of admission instead of focusing on treating a patient to the best of their abilities,” Roberts said. “We need to focus on ensuring rural patients have access to the health system, not come up with bureaucratic ways to make it harder for patients in rural areas to get quality care from their doctors.”
“Putting arbitrary limits on how many hours patients can stay in critical access hospitals is dangerous and violates the trust patients put in their doctors and nurses,” Tester said. “Critical access hospitals play a vital role in providing quality and affordable healthcare in rural communities, and we shouldn’t shortchange the care someone receives because of their zip code.”
The bill — the Critical Access Hospital Relief Act of 2014 — removes the “condition of payment” for Critical Access Hospitals that requires a physician to certify upon admission that each patient will be discharged or transferred in less than 96 hours.
At issue is whether the hospital can be reimbursed if for instance a physician certifies that they expect the patient to be treated and discharged within 96 hours, but the situation changes and the patient must be kept longer. The physician will be faced with a scenario in which they have failed to meet the terms of their certification. This is likely to lead to premature discharges and re-admissions, both of which CMS has taken actions to minimize. In some cases rural patients may be forced to travel to an urban hospital a great distance away.
Roberts is a co-chairman of the Senate Rural Health Caucus. He is the ranking member of the Senate Finance Committee’s Subcommittee on Health Care.