Loss of the Medicare Dependent Hospital program (MDH) and the Medicare add-on payment known as the Low-Volume Hospital adjustment (LVH), both of which expired on September 30, must be addressed quickly by this aptly-labeled “do-nothing” Congress. Payment uncertainty coupled with the harshness of sequestration, burdensome health reform regulations and continued workforces shortages, will force many of these fiscally fragile facilities to their breaking point.
Indeed, the fate of many rural hospitals could be decided in the next few weeks. An NRHA meeting last week with the staff of Senator Chuck Grassley (R-IA), a champion of the MDH program, indicates that some modest Congressional movement is occurring. Finally, there is a glimmer of hope.
Grassley, co-sponsor of legislation to extend the MDH and LVH payments for one year, confirmed that discussions for a Senate Finance Committee bill on the SGR (or “doc fix”) is getting momentum to include a retroactive fix to the MDH and LVH programs, as well as certain other “rural extenders.” That’s the good news. The not-so-good” news is the stark declaration that LVH will likely be modified to “better target” hospitals truly in need of the add-on payment. Exact modifications, language and timing are completely unknowable until after the election.
NRHA advice? Don’t rest. Tentative discussions by Senate Committee staff prior to an election where the balance of power in the Senate could easily shift should not make any hospital comforted that this is a done deal. In fact it’s time to double-down on efforts.
So, get your campaign on. No yard signs or bumper stickers needed. Simply sign a letter to Congressional leaders demanding that rural hospitals be protected (by emailing David Lee of NRHA at dlee@nrharural.org). Get others to sign. Go to a town hall, a Congressional District office, or send an email to your Congressional delegation. Make sure everyone one on the ballot knows that rural health care matters.