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Kaiser Health News reporters tell us that U.S. Senators continue to push for higher Medicare payments to rural hospitals in their states even as they decry budget deficits and an expensive health care reform bill. Eric Pianin and Mary Agnes Cary write that several senators want to help local hospitals become declared “critical access” facilities, a designation that allows these hospitals to collect higher payments from Medicare. Meanwhile, KHN reports, the “same senators are among those pushing hardest to hold the line on the cost of health care reform.”

Senators Wyden (Oregon), Brownback (Kansas), Pryor (Arkansas) and Conrad (North Dakota) are among those seeking special designation of rural hospitals as “critical access” facilities. Congress created this designation in 1997 to help ensure care in isolated parts of the country. The original law said hospitals farther than 35 miles from other health facilities could be declared “critical access” and then collect 101% of their costs from Medicare rather than the usual 95% of allowable costs. The 35 mile limit was routinely waived, however, and the number of “critical access” hospitals grew to over 1,200 when Congress eliminated all waivers to the 35-mile rule in 2006.

“Now lawmakers from rural states want to ease the rules, partly by making it easier for hospitals to qualify for “critical access” status even if they are less than 35 miles from another facility,” the reporters write. “Supporters note that the hospitals, besides providing emergency and limited inpatient treatment, are often the mainstays of small-town economies.”

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