Empowering Rural Health Providers

Nebraska’s Third District is home to 55 Critical Access Hospitals. Though they all share the same designation, no two are alike in the ways they meet the needs of their communities.

Rural hospitals know best how to care for their patients, not bureaucrats in Washington. As a member of the Ways and Means Committee and chairman of the Congressional Rural Caucus, I have been working on legislative solutions to bring relief to providers. We have also held a number of hearings since the start of the new Congress to explore ways to reduce regulatory burdens and improve rural health.

The 96-hour rule is a prime example of burdensome red tape. This regulation requires physicians at Critical Access Hospitals to certify at the time of admission Medicare patients will not be there more than 96 hours. Otherwise, the hospital must transfer the patient or face non-reimbursement.

In June, the Centers for Medicare & Medicaid Services (CMS) finalized a rule stating enforcement of the 96-hour rule would be a “low priority.” This is a good start, but some Nebraska providers have told me since the 96-hour rule is still written in statute, they fear non-compliance could result in a retroactive penalty if a new administration changes the policy.

In other words, until there is a legislative fix, some feel they must continue to enforce the 96-hour rule out of fear of being penalized in the future. Providers should only have to think about what’s best for their patients, not what could happen down the road due to an ambiguous regulation.

In the last Congress, I introduced the Critical Access Hospital Relief Act to repeal this burdensome rule, and I continue to work with my colleagues on legislative solutions. In our hearing this week with Department of Health and Human Services Secretary Alex Azar, I asked him to help us deliver permanent relief.

Rural hospitals are also on the front lines in the fight against opioid addiction, which is one of the most devastating public crises our country faces. Our Ways and Means Health Subcommittee hosted a hearing earlier this month on protecting Medicare beneficiaries from opioid abuse. The main message was clear – it is vital we empower local providers to combat this epidemic.

Opioid addiction is a major driver of poverty and unemployment, which reinforces a devastating cycle. I chair the Ways and Means Human Resources Subcommittee, where we are focused on helping more Americans achieve self-sufficiency.

Right now, more than seven million men and 5.5 million young adults are missing from the workforce. Our goal is to help these Americans get off the sidelines and experience the dignity of work so more people can benefit from the economic growth we are already seeing from tax reform.

The most valuable tool in shaping effective rural health policies in Congress is to hear directly from the professionals working in the midst of these challenges each day. To the many Third District providers who dedicate themselves to ensuring high-quality care for Nebraskans, thank you for your work. Please keep in touch with me on how I can help reduce government burdens.