Bill Addresses Rural Healthcare

On May 20, 2014, Senators Al Franken (D-MN), Pat Roberts (R-KS), Tom Harkin (D-Iowa), and John Barrasso (R-WY) introduced a bipartisan bill to help rural communities address the challenges rural communities face when it comes to providing quality healthcare.

“Providing quality healthcare to Minnesota’s rural communities requires innovative solutions,” said Senator Franken who was recently named co-chair of the Senate Rural Health Caucus, as Co-Chair Tom Harkin retires this year. “We can’t afford to ignore the complexities of healthcare delivery in our rural communities.”

The legislation called the “Craig Thomas Rural Hospital and Provider Equity Act” (R-HoPE) (S 2359) would provide the following provisions:

  • Provide for telehealth services across state lines
  • Equalize Medicare Disproportionate Share Hospital Payments
  • Temporary improvements to the Medicare inpatient hospital payment adjustment for low-volume hospitals
  • Continuation of geographic reclassification for certain hospitals in sparsely populated states
  • Reasonable lab costs and payment extension for rural hospitals for services
  • Critical Access Hospitals need to be appropriately reimbursed for providing emergency medical services
  • Loans will be available to help rural facilities improve aging buildings and infrastructure and rural providers to apply for planning grants
  • Extend the Medicare incentive payment program
  • Extend the physician fee schedule work geographic adjustment
  • Enable physician assistants to order post-hospital extended care and provide hospice care to their patients who elect Medicare’s hospice benefit
  • Provide more help for home health patients
  • Increase rural health clinic reimbursements and rural home health add on payments
  • Increase add on payment for rural ambulance service provider to 5 percent
  • Increase mental health providers that can bill for mental health services provided to Medicare beneficiaries
  • Make a regulatory change mandating that hospitals not Medicare pay independent laboratories for services
  • Improve access to anesthesiology services
  • Increase the physician fee schedule practice expense geographic adjustment
  • Revise the standard for designating sole community hospitals
  • Reimburse Critical Area Hospitals for CRNA On-Call Services
  • Reauthorize grants to go to states to operate Offices of Rural Health
  • Remove the Medicare 96 hour Physician Certification Requirement for inpatient Critical Access Hospital Services


The bill was referred to the Senate Committee on Finance. For more information, go to

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