April 20, 2020

Weekly Column: Backing Rural Providers

Guest column submitted by U.S. Senator Mike Crapo

Making sure health care providers, big and small, have the resources necessary to keep those on the frontlines safe and combat the novel coronavirus, or COVID-19, is the most important part of the fight against this disease.  The University of Chicago recently released a “U.S. COVID-19 Atlas” indicating emerging hotspots in rural areas.  Many already cash-strapped rural health care providers with oftentimes only a handful of emergency medical personnel and very limited bed space are responding to critical cases that stretch or exceed their facilities and exhaust supplies.  We must make certain needed resources quickly reach rural providers and are not just focused on large providers in major metropolitan areas.

Congress and the Trump Administration worked together to enact three phases of legislation providing resources to support health care providers in the fight against COVID-19.  Phase 3 of the emergency coronavirus response legislation, the bipartisan Coronavirus Aid, Relief, and Economic Security (CARES) Act, provides further flexibility and funding to fight this unprecedented crisis.  In addition to putting needed cash into the hands of American workers and families, providing relief to small businesses and helping stabilize our economy, the CARES Act sends a massive new infusion of resources to the front lines of the medical response. 

  • The Medicare sequester, which automatically reduces provider reimbursements by two percent, would be immediately suspended for all health care services. 
  • Hospitals would receive an additional 20 percent Medicare payment for the treatment of patients with COVID-19, and $100 billion in grants to build critical infrastructure, expand the health care workforce and cover uncompensated expenses. 
  • The expansion of telehealth services would enable patients to consult their providers from home, mitigating the risk of exposure for vulnerable populations and keeping providers healthy. 
  • Providers in Rural Health Clinics and Community Health Centers would be eligible to conduct telehealth visits, and Health Resources and Services Administration grants would be reauthorized to support the use of telehealth technology.
  • New flexibilities would allow qualified physician assistants, nurse practitioners and clinical nurse specialists to order home health services for Medicare beneficiaries. 
  • Home health providers would also be encouraged to use remote patient monitoring and other telecommunication technologies for continuity of care. 

These are some of the provisions of the bill focused on assisting rural providers.  I serve on the Senate Finance Committee, and our Committee’s Chairman Chuck Grassley (R-Iowa) provided a summary of the provisions of the CARES Act focused on assisting patients and providers in rural areas hard hit by COVID-19.  The full list of highlights is viewable at https://www.finance.senate.gov/chairmans-news/rural-resources-in-the-coronavirus-aid-relief-and-economic-security-cares-act.

I joined a bipartisan group of fellow senators, including fellow Idaho Senator James E. Risch, on a letter led by Senators John Barrasso (R-Wyoming) and Michael Bennet (D-Colorado) to U.S. Secretary of Health and Human Services (HHS) Alex M. Azar II urging the agency to prioritize financial relief of rural hospitals.  We wrote, “Right now, some rural hospitals are reporting they are running out of operating funds.  This jeopardizes their ability to maintain health care services during the COVID-19 outbreak.”  We requested the Administration’s rapid action to sustain rural providers. 

On April 10, the Administration began releasing part of the $100 billion in provider grants.  Idaho is expected to receive about $135 million in immediate relief funds from this first phase of distribution to be allocated to 1,864 Idaho providers and health systems based on 2019 Medicare fee-for-service claims.  As the Administration continues to allocate the $100 billion grant program through the HHS and other resources, I will continue to advocate for the needs of all of Idaho—including our rural health providers.

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