The following update was provided by Hall Render, NOSORH Legislative Liaison:

Senate Introduces Bipartisan Bill to Increase SORH Budget

On September 28, Senator Pat Roberts (R-KS) and Al Franken (D-MN) introduced a comprehensive rural health bill (S. 3435) that would raise the annual budget for State Offices of Rural Health (SORH) to a minimum of $150,000.  The bill would also reauthorize the SORH Grant Program (Sect. 338J of the Public Health Service Act) for the first time since its creation in 1992.

With Congress leaving town ahead of the November elections, the Rural Hospital and Provider Equity Act of 2016 (R-HoPE) will not pass the Senate this Congress, but for the first time, Senate legislation has been introduced to raise the annual federal grant amount for SORH from $50,000 to $150,000.  NOSORH will seek to have Sect. 24 of the R-HoPE bill included and passed in additional legislation in the 115th Congress, which begins in January.

In addition to the SORH language, S. 3435 would extend several programs that provide access to hospitals, doctors, and rural health services including:

  • Extension of the Medicare-dependent hospital (MDH) program;
  • Extension to the Medicare inpatient hospital payment adjustment for low-volume hospitals;
  • Reinstatement of Medicare wage index reclassifications for certain hospitals;
  • Extension of Medicare incentive payment program for physician scarcity areas;
  • Extension of floor on Medicare work geographic adjustment;
  • Removing Medicare’s 96-hour physician certification requirement for inpatient critical access hospitals services; and
  • Increase Medicare payments for rural ground ambulance services.

Senate Advances Stopgap Spending Bill

On September 28, the U.S. Senate and House of Representatives passed a 10-week continuing resolution (CR) which funds the federal government at fiscal year (FY) 2016 levels through December 9, 2016.  The new December 9 deadline, will provide Congress three weeks of scheduled legislative business to either pass a FY 2017 spending bill or further extend funding at FY 16 levels.

Senate Democrats had blocked cloture on the CR, but their objections were resolved when Congressional leaders reached a deal that included aid to Flint, Michigan, through separate authorizing legislation.  The action by both chambers provides ample time for President Obama to sign the spending resolution into law before the current fiscal year expires on October 1.

Long Term Care, Rural Hospital Bills Pass House

On September 21, the House passed a bill sponsored by Rep. Lynn Jenkins (R-KS) that would further delay a CMS rule requiring physicians to be present for minor outpatient procedures.  In both 2014 and 2015, Congress has passed a moratorium on CMS enforcing the physician supervision requirement which impacts critical access and rural hospitals.

On September 20, the House of Representatives passed a bill intended to provide relief to Long-Term Care Hospitals from the “25 percent rule.”  The CMS rule, which has been delayed by Congress for years, allows for no more than 25 percent of patients to come from one inpatient acute care hospital in one quarter.  The threshold was 50 percent, but CMS is phasing back in the 25 percent threshold.

The House passed bill, H.R. 5713, which was sponsored by Ways and Means Health Subcommittee Chairman Pat Tiberi (R-OH) passed 420-to-3.  The bill would reinstate the 50 percent threshold that was in effect prior to July 1, 2016 and delay the rule for long-term care hospital discharges between October 1, 2016 and June 30, 2017.  The House would pay for the nine-month delay with a fraud and abuse measure outlined in the president’s proposed budget.

House Committee Passes Six Public Health Bills

On September 20, the House Energy and Commerce Committee advanced six public health bills.  Among the six bills that passed by voice vote:

  • A bill by Rep. Richard Hudson (R-NC) would permit trained Emergency Medical Service professionals to administer controlled substances governed by the Controlled Substances Act to patients in a non-hospital setting under the supervision of a physician. The bill (H.R. 4365) would also allow hospitals to restock emergency medical vehicles with controlled substances without adhering to certain federal regulations.
  • A bill (H.R. 1209) sponsored by Rep. Michael Burgess (R-TX) would mandate that the federal government collect further information on primary care professional shortage areas specifically for maternity care. The bill (H.R. 1209) would allocate maternity care providers based on an area or population’s specific needs.
  • R. 2713 is a bill sponsored by Rep. Lois Capps (D-CA) that would reauthorize the Health Resources and Services Administration’s nursing workforce development programs through fiscal year 2020 and update the programs to reflect current nursing practices.
  • Finally, a bill sponsored by Rep. Lynn Jenkins would reauthorize a federal grant program for mental health first aid training courses by expanding training to help emergency services, police officers, educators, and the public identify and respond to people experiencing mental health issues and substance use disorders.

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