Designating rural hospitals as Medicare Critical Access Hospitals (CAH) would provide them financial relief and help keep them open in needy communities around the country, U.S. Rep. Adam Kinzinger (R-IL) wrote in a July 31 bipartisan letter.
“We support your efforts to explore and test new solutions for rural healthcare challenges through new payment structures and demonstration programs … but it is imperative that we utilize existing models to stop and prevent a wave of rural hospital closures as we work to analyze and critique these new solutions,” wrote Rep. Kinzinger along with U.S. Sen. Dick Durbin (D-IL) in their letter to U.S. Secretary of Health and Human Services (HHS) Alex Azar.
Since 2010, the lawmakers pointed out that there have been 108 rural hospital closures nationwide, with 11 closures already this year.
At the same time, roughly 46 percent of rural hospitals are currently operating at negative margins — heightening their financial risks, according to their letter.
“The Critical Access Hospital designation is a narrow, immediate and common-sense way to stop the bleeding of this crisis and would be a huge step in solidifying the delicate healthcare infrastructure that is so common in rural communities across the country,” wrote Rep. Kinzinger and his colleague.
Congress created the CAH designation in 1997 in response to a wave of rural hospital closures during the 1980s and 1990s, the congressmen wrote.
The designation since has been amended, including through the 2003 Medicare Prescription Drug, Improvement and Modernization Act, which since 2006 has disallowed states to waive the 35-mile distance requirement for facilities they deemed a “necessary provider” to receive CAH status, they wrote.
If HHS would deem “certain vulnerable rural hospitals” as CAHs, then the department could include “waiving the distance requirement, reinterpreting the secondary road definition, or other flexibilities,” wrote the lawmakers.
“Using such administrative flexibility, HHS could establish clear eligibility criteria, in consultation with states, to ensure an appropriate set of rural safety net facilities could access CAH status,” according to their letter.