Schumer, Stefanik: Feds reverse court on hospital reimbursement policy

WATERTOWN — U.S. Senate Majority Leader Charles E. Schumer and Rep. Elise M. Stefanik announced Friday that the federal government has reversed course on a policy that threatened to cost many rural hospitals — including several in the North Country — millions of dollars in reimbursements for servicing Medicare, Medicaid and Tri-Care patients.

Sen. Schumer, D-N.Y., said in a statement that the Centers for Medicare and Medicaid Services (CMS) has undone a previous rule change that placed nine hospitals in the state in danger of losing their Critical Access Hospital (CAH) designation.

That status enables the facilities to receive federal reimbursement for some services that can help keep smaller, rural hospitals viable.

Rep. Stefanik, R-Schuylerville, said in a statement that she has been fighting the policy change “for years.” In January 2021, she introduced Protecting Rural Access to Care Act, legislation designed to protect the CAH designation.

“I am proud to announce that, following my advocacy, families in rural communities are no longer at risk of losing access to rural hospitals,” Rep. Stefanik said in her statement. “The Critical Access Hospital designation is vital for hospitals and healthcare centers in the most rural parts of America to continue providing quality care. Now, this proposed fix will protect healthcare access in rural communities and ensure vulnerable hospitals are not at risk of losing their designation.”

To receive critical access status, a hospital must be more than 35 miles away from another hospital that provides critical care, and meet other requirements.

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 and Medicaid Services, which is run by the U.S. Department of Health and Human Service, adjusted requirements and changed how it calculates the distance between hospitals, redefining what qualified as a “secondary road.”

That policy change was not immediately implemented due to the COVID-19 pandemic, but it remained on the books ready for enforcement.

Sen. Schumer and Rep. Stefanik, as well as others, pushed the Department of Health and Human Services to rescind the policy change.

In the North Country, Carthage Area Hospital, Gouverneur Hospital, Lewis County General Hospital, River Hospital in Alexandria Bay and Clifton-Fine Hospital are designated as CAHs.

According to Sen. Schumer, Carthage Area Hospital received $9.7 million in CAH program reimbursements in 2020, while Lewis County General received $5.3 million and Gouverneur Hospital received $3.3 million.

A reimbursement figure for River and Clifton-Fine hospitals was not available.

“Upstate families in rural communities from Jefferson to Delaware County depend on their local hospitals for lifesaving care and essential medical procedures. I promised our rural hospitals that I would not stop fighting until these rules changes were fixed and their Critical Access Hospital designation was ensured,” Sen. Schumer said in his statement.

“Now I am proud to announce that rural communities from the North Country to the Southern Tier can breathe a sigh of relief as these essential healthcare providers will continues to receive the millions in federal reimbursements they need and deserve to keep saving lives.”

In total, CAHs across the country expect to receive about $35 million annually in reimbursements to help maintain their viability, the senator said.


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