Regulations Obstruct Rural Health Care

Rural Nebraska truly is the heartland of America. I grew up here, and would never live anywhere else. While there are many advantages and benefits to living in rural areas, there are also challenges. As the Representative of one of the most rural congressional districts, I have focused on expanding opportunity in rural America, and I have fought laws and regulations, especially those which disproportionately impact less populated areas.

Access to quality health care is a challenge for rural communities even without the heavy hand of government. A doctor shortage makes it difficult to recruit quality physicians, particularly primary care physicians, to small remote facilities. And the distance between providers can be an obstacle for those living outside of cities and towns.

Nebraska’s Third District is blessed to have outstanding hospitals and clinics, doctors, and other health care professionals. Despite the challenges, rural Nebraskans can still receive treatment for most of their medical needs without having to travel to big cities like Omaha, Lincoln, or Denver. However, federal policy too often threatens access to care with new and unnecessary regulations.

For example, the Centers for Medicare and Medicaid Services (CMS) recently announced it would begin enforcing the ’96-hour rule’ on small, remote facilities known as Critical Access Hospitals. This arbitrary rule requires physicians at our rural hospitals to certify Medicare and Medicaid patients will not be at the hospital for more than 96 hours. Otherwise, the hospital must transfer the patient to a more distant facility at the cost of taxpayers, or face non-reimbursement.

This rule places an extreme hardship on these hospitals, doctors, and patients. It forces doctors to follow arbitrary bureaucratic rules instead of acting only in the best interest of patients. And it would force many patients to receive treatment outside of their communities for no clinical reason.

After hearing the concerns of many Nebraskans, I introduced the Critical Access Hospital Relief Act to repeal the 96-hour rule. This legislation would cut through the red tape and allow rural providers to focus on taking care of their patients instead of complying with burdensome and arbitrary regulations. I greatly appreciate the support I have received for this bill from rural Nebraskans, Critical Access Hospitals, and the Nebraska Hospital Association.

I have also introduced legislation to delay enforcement of physician supervision regulations at Critical Access Hospitals. These too are an example of an unneeded federal regulation burdening our rural facilities. They require a doctor’s presence and supervision over nearly all routine procedures administered in hospitals. While these requirements are less of a challenge for large hospitals, they can be very problematic in areas with few doctors.

Critical Access Hospitals simply do not have the man power and resources to abide by these supervision regulations. My legislation would delay enforcement of these rules, and require an analysis of their impact so regulators understand how destructive these requirements would be for rural providers.

There are 52 Critical Access Hospitals in the Third District, but more importantly, there are hundreds of thousands of Nebraskans who depend on these facilities for medical care. As a member of the House Committee on Ways and Means which has jurisdiction for these bills, I will work for their consideration and passage as we continue to offer solutions for the many problems in our health care system. Access to health care for rural communities is necessary to make sure rural Nebraska remains a great place to live.