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Issues: Rural Health“Without basic services such as health care, rural areas cannot hope to attract new residents or retain existing residents. That is why I have worked to improve access to health care in rural areas by ensuring that rural hospitals and providers have the resources they need to keep their doors open.”
When the federal bureaucracy arbitrarily lowered the reimbursement rate for rural hospital lab services for less than its cost, Senator Nelson introduced legislation to overturn the regulation. The regulation stated that lab services would not be reimbursed by CMS unless the patient is at the facility where testing will occur. This change jeopardizes rural Nebraskans’ access to care by imposing an additional burden on the frail elderly by requiring them to visit the hospital to get simple lab tests done. The additional time and expense incurred by the patient is unnecessary if the Critical Access Hospital (CAH) is willing and able to conduct tests at the point of patient care and transport it back to the hospital for analysis. Sixty-one rural hospitals in Nebraska were impacted by the regulation, costing some of these facilities hundreds of thousands of dollars. Senator Nelson worked with Senator Brownback (R-KS) to introduce legislation to create the new designation of “rural community hospital” for hospitals with between 25 and 50 beds. Under this proposal, which was included as a pilot program in the Medicare Modernization Act of 2003, 15 rural community hospitals – including five in Nebraska – will receive cost-based Medicare reimbursements, allowing them to recoup their costs of providing care as well as to maintain their facilities by making necessary improvements. Senator Nelson voted for legislation to end Medicare’s historic discrimination against states that do more with less. Medicare’s complex funding formula penalized rural states such as Nebraska for practicing cost-effective medicine by reimbursing them at a lower rate. Health care providers and hospitals in Nebraska received a lower reimbursement for the same procedure performed in New York. This practice created a disincentive for doctors and nurses to stay in rural areas and hurt hospitals that were already struggling financially. The legislation Senator Nelson supported helped equalize the reimbursement rate between urban and rural America. Senator Nelson understands the difficulty rural areas face when trying to recruit physicians. Senator Nelson cosponsored legislation that provides a special visa to foreign doctors who agree to spend three years serving in the state. The program has been successful in retaining these physicians with 83 percent of those who have served in Nebraska remaining past their assigned period of time.
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As a native of McCook, Senator Nelson understands how important health care is to the survival of rural communities. Without basic services such as health care, rural areas cannot hope to attract new residents or retain existing residents. That is why Nebraska’s Senator Ben Nelson has worked to improve access to health care in rural areas by ensuring that rural hospitals and providers have the resources they need to keep their doors open. Rural hospitals are a lifeline for many Nebraska communities. Unfortunately, many of these rural hospitals are facing a financial crisis. Currently, the amount hospitals receive from Medicare is pre-set by bureaucrats in Washington without regard to the special circumstances facing rural hospitals.