Rep. Elise Stefanik, R-Schuylerville, speaks prior to introducing Vice President Michael Pence at Wheeler-Sack Army Airfield at Fort Drum on Jan. 17, 2021. (Provided photo — Sydney Schaefer, Watertown Daily Times)

In an effort to assure a number of North Country hospitals continue to receive special benefits to help them remain financially stable, Rep. Elise Stefanik introduced legislation Monday to aid in the fight.

With Rep. Antonio Delgado, D-Rhinebeck, who represents New York’s 19th Congressional District, Stefanik, R-Schuylerville, introduced the Protecting Rural Access to Care Act. The bill is meant to ensure rural hospitals currently designated as critical access hospitals are able to maintain that status, which gives them higher Medicare reimbursement rates and access to special grant programs.

Stefanik and Delgado introduced the same legislation together in August of last year, but the bill was sent to committee and never moved forward.

To receive critical access status, a hospital must be more than 35 miles away from another hospital that provides critical care. In rural and mountainous regions, as well as places where only secondary, smaller roads are available, that requirement drops to 15 miles.

In 2015, the Centers for Medicare & Medicaid Services adjusted requirements and changed how the agency calculates distance between hospitals, redefining what qualifies as a secondary road. That put a number of New York state’s 18 critical access facilities at risk of losing access to the program’s benefits once they begin re-certification.

The Protecting Rural Access to Care Act addresses that rule change, requiring hospitals given critical access status before the 2015 rule change are still evaluated under the old rules when they go through re-certification.

Karoline Leavitt, spokeswoman for Stefanik, said at least two of the four critical access hospitals in New York’s 21st Congressional District — Lewis County General Hospital in Lowville and Gouverneur Hospital — are up for re-certification soon and could be impacted by the new distance requirements. Other critical access hospitals in the district are River Hospital in Alexandria Bay and Clifton Fine Hospital in Star Lake, although neither is slated for re-certification anytime soon.

Stefanik said she worked with area hospitals and the administration of former President Donald Trump to pause the program’s re-certification process during the COVID-19 pandemic, preventing hospitals up for review from losing their designation. Monday’s legislation is meant to be a more permanent solution for hospitals in the program, and also ensures new critical access hospital certifications are made following the pre-2015 rules until CMS issues new guidance. Under the bill, CMS would also be required to take public comment regarding any future rule changes.

In a joint press statement with the congresswoman, North Country hospital officials expressed how important critical access-designated facilities are to the health care system in the region.

Gerald Cayer, chief executive officer of Lewis County General Hospital, explained that critical access designation was created in 1997 to address a slew of rural hospital closures that occurred throughout the 1980s and 1990s.

“Our elected leaders back then had the foresight to see the important role rural hospitals played in providing local access to vital health care services,” he said.

Cayer said that without alteration, the 2015 rule change would significantly hurt critical access facilities and rural communities nationwide.

“Critical Access Hospitals have been the cornerstone for providing quality healthcare to rural communities,” Rich Duvall, CEO of Carthage Area Hospital, said in a prepared statement. “Without them, patients would have to travel long distances to receive care.”

Both said the Protecting Rural Access to Care Act, if passed, will ensure that critical access facilities will be able to survive and continue providing care in their communities.