Bills to Improve Access to Rural Healthcare

Representatives Terri Sewell (D-AL) and Adrian Smith (R-NE) are both members of the House Ways and Means Committee and represent rural congressional districts. Together on in early February, the Representatives introduced two bills to improve rural access to healthcare.

The first bill H.R. 1041, “Critical Access Hospital Relief Act” would repeal Medicare’s 96 hour rule which requires a medical facility to either discharge or transfer a patient within four days of admittance.

According to the Representatives, this arbitrary deadline amounts to an undue burden on both hospitals and patients in rural areas where hospitals are typically more distant from one another and may force a choice between early discharge and a long expensive transfer. While CMS has temporarily addressed this issue through rulemaking, the bill would ensure it is addressed permanently.

The second bill H.R 1052, “Physician Assistant Direct Payment Act” will allow physician assistants to be directly compensated by Medicare in order to expand their role as medical providers in underserved communities.

At present physician assistants are the only providers allowed to bill Medicare for services rendered, but are required to have their payments routed through a third party such as a physician or hospital.

As Representative Sewell stated, “Our Medicare payment policies must eliminate barriers that stand in the way of our ability to attract qualified medical talent such as physician assistants to rural and underserved areas.”

Representative Smith said, “The repeal of Medicare’s 96 hour rule and allowing physician assistants to be paid directly by Medicare are two examples to ensure that rural Americans receive better care.”

For more information on both bills, go to

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