Rural Health Policy Update

June 2023

Senate Holds Rural Health Hearing:   
For the first time since 2018, the Senate Finance Committee held a hearing on rural health. On the afternoon of May 17, the Senate Finance Health Care Subcommittee met to focus on the challenges hospitals, physicians, and rural communities face. The hearing touched on provider shortages, infrastructure decline, telehealth access, value-based care models, and other topics. Witnesses from rural hospitals in Montana and Minnesota testified before the Committee and others.   

The Committee holding a hearing on a topic is generally a way to build the record toward introducing a rural health legislative package later this year or next. Here is Ranking Member Daines’ opening statement at the hearing. The action by the Finance Committee potentially sets the stage for the reauthorization of the Medicare Rural Hospital Flexibility program, a major NOSORH-led initiative that NOSORH has been lobbying Congress on this year.   

House Committee Advances Major Health Care Package: 
The big ticket health care item in May was the House Energy and Commerce Health Subcommittee’s markup of 17 healthcare bills. Many of the bills were rolled into a larger package (H.R. 3281, the Transparent PRICE Act). Included in this package were: PBM oversight, a two-year amnesty from pending DSH payment cuts, reauthorization for continued funding for community health centers, the National Health Service Corps, teaching health centers that operate GME programs, and a diabetes program. The package is paid for by eliminating remaining funds in the Medicaid Improvement Fund and including a site-neutral policy impacting payment for physician-administered drugs. One of the more hotly contested bills was a measure by Rep. Bucshon (H.R. 3290) which would amend the Public Health Service Act to ensure transparency and oversight of the 340B drug discount program. The measure advanced on party line by a 16-12 vote.   

Rural Health-Related Bills Introduced in May: 
On May 25, Reps. Smith (R-NE), Blumenauer (D-OR), Armstrong (R-ND), and Tokuda (D-HI) introduced H.R. 3730, the Rural Health Clinic Burden Reduction Act. The bill seeks to modernize provisions relating to Rural Health Clinics. A companion bill was introduced earlier this year in the Senate by Senator Barrasso (R-WY).   

Earlier in May, Senators Cassidy (R-LA), Cortez Masto (D-NV), Collins (R-ME) and Stabenow (D-MI) introduced a rural ambulance improvement bill. The bill, S. 1673, seeks to ensure rural areas have access to quality emergency ambulance services. The bill helps ambulance providers hire and retain EMT staff, update their equipment, and provide medical care in rural areas.    

Senator Dick Durbin and James Lankford (R-OK) introduced S. 1571, the Rural Hospital Closure Relief Act, which seeks to restore state authority to waive for certain facilities the 35-mile rule for designating Critical Access Hospitals under Medicare. Here is the Lankford press release.   

Senator Josh Hawley (R-MO) and Gary Peters (D-MI) introduced S. 1560, the Rural Hospital Cybersecurity Enhancement Act.

Update Provided by Hall Render, NOSORH Legislative Liaison.