Rural Medicare programs get short-term extensions from Congress

Two Medicare programs that boost payments for hundreds of rural hospitals were extended through mid-December with the House’s passage of a short-term federal spending package on Friday.

On the House’s mostly partisan 230-201 vote, Congress averted a government shutdown on the last day of the fiscal year. The Senate passed the appropriations package on Thursday.

House members and senators will return to their districts and states to campaign for the Nov. 8 midterm elections. Congress plans a lame duck session to address any unfinished business from this session after the elections.

Had Congress failed to act before Saturday, the Medicare Dependent Hospital program would have expired and the Low-Volume Hospital program would have lost the expanded eligibility criteria lawmakers authorized in 2018, which allowed more hospitals to participate.

Bipartisan bills have been introduced to permanently broaden the programs, including legislation sponsored by Sen. Bob Casey (D-Pa.) and Rep. Sam Graves (R-Mo.)

Groups such as the American Hospital Association and Federation of American Hospitals have voiced support for these measures, as well as for stopgap appropriations funding, as rural hospitals are contending with serious financial challenges from the ongoing COVID-19 pandemic.

About 180 hospitals, or 6% of inpatient prospective payment system facilities, qualify for the Medicare Dependent hospital program, which mandates that at least 60% of the institution’s patients are covered by Medicare.

The Low-Volume Hospital program previously applied to facilities located more than 25 miles from the nearest hospital that discharge fewer than 200 patients a year. Congress expanded eligibility in 2018 to include hospitals that discharge fewer than 3,800 patients per year and are located more than 15 miles from the nearest hospital.

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