House Committee Holds Hearing on the Impact of Medicare Regulations on Rural Health
July 31, 2015 03:06 PM
The House Ways & Means Health Subcommittee convened a hearing on Tuesday, July 28, to discuss the impact of Medicare regulations on the delivery of care in rural areas.
Subcommittee Chairman Kevin Brady (R-TX) in an opening statement said the impact of Medicare regulation is an “important issue for all of us, but the challenges facing rural beneficiaries and providers are especially evident to those of us who represent districts that aren’t completely urban. Our constituents are seeing firsthand the difficulties caused by overregulation and bureaucracy. And it is our rural neighbors who pay the price when it comes to access.”
As an example, Brady stated that rules preventing physician assistants from serving as hospice attending physicians are particularly problematic in rural areas. “Rules that change the way routine therapeutic services are handled in rural areas or rules that bar physician assistants from providing services, like hospice, disrupt access and the continuity of care for rural beneficiaries.”
“We can do better, we must do better, and we will do better. We should provide relief for all our hospitals and providers from overly burdensome regulations and bureaucracies,” Brady said.
In addition to raising concerns about CMS’ physician supervision requirements, Representative Lynn Jenkins (R-KS) expressed concern about the fact that Medicare’s list of authorized hospice providers “is not as inclusive as it should be and could lead to gaps in access.” Jenkins highlighted her bill, the Medicare Patient Access to Hospice Act of 2015 (H.R. 1202), which would allow physician assistants to serve as attending physicians for hospice care. (See previous NAHC Report article on H.R. 1202 here).
When Jenkins asked the witnesses for their opinions on allowing physician assistants to serve as attending physicians for hospice care, Carrie Saia, CEO of Holton Community Hospital in Holton, Kansas, responded: “I think it’s being very futuristic and very supportive of trying to keep the hospice patient in their local community to receive important services at a very critical time, instead of having them leave their local community to receive it elsewhere.”
Another issue Representative Mike Thompson (D-CA) highlighted was the importance of promoting telemedicine and telemonitoring. “I’m a big supporter of telemedicine and telemonitoring,” he said. “I think it’s a way we can address a lot of the problems that we face.” Thompson asked the witnesses to provide any policy or legislative changes that can help them “do more or better telehealth.” The witnesses responded in agreement that upfront implementation costs and reimbursement issues are significant barriers to the adoption of telehealth.
The National Association for Home Care & Hospice supports changes to Medicare regulations that promote access to care in rural areas. In addition to supporting legislation allowing physician assistants to serve as attending physicians for hospice care, NAHC supports legislation that would allow physician assistants and nurse practitioners to certify home health services (see previous NAHC Report article here). NAHC supports additional measures to improve the delivery of care in rural areas such as the permanent extension of the Medicare rural add-on (see NAHC Report article here). With regards to the adoption of telehealth, NAHC supports providing incentives for home care and hospice providers to adopt telehealth.
For more information about the hearing, including the witnesses and testimony, please click here.