[Congressional Bills 108th Congress]
[From the U.S. Government Publishing Office]
[H. Res. 267 Introduced in House (IH)]






108th CONGRESS
  1st Session
H. RES. 267

 Expressing the sense of the House of Representatives that there is a 
   need to protect and strengthen Medicare beneficiaries' access to 
                 quality health care in rural America.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             June 10, 2003

     Mr. Bereuter (for himself, Mr. King of Iowa, Mr. Peterson of 
Pennsylvania, Mr. Stenholm, Mr. Hinchey, Mr. Towns, Mr. Taylor of North 
Carolina, Mr. Leach, Mr. Shuster, Mr. Oberstar, Mr. Janklow, Mr. Moran 
  of Kansas, Mr. Tanner, Mr. Goode, Mr. Nethercutt, Mr. Sweeney, Mr. 
 Paul, Mr. Latham, Mr. Davis of Tennessee, Mr. Stupak, Mr. Renzi, and 
Mr. Osborne) submitted the following resolution; which was referred to 
the Committee on Energy and Commerce, and in addition to the Committee 
 on Ways and Means, for a period to be subsequently determined by the 
  Speaker, in each case for consideration of such provisions as fall 
           within the jurisdiction of the committee concerned

_______________________________________________________________________

                               RESOLUTION


 
 Expressing the sense of the House of Representatives that there is a 
   need to protect and strengthen Medicare beneficiaries' access to 
                 quality health care in rural America.

Whereas approximately 22 percent of Americans living in non-metropolitan areas 
        are Medicare beneficiaries;
Whereas all Medicare beneficiaries should be able to receive equitable access to 
        health care services regardless of where they live;
Whereas hospitals located in cities with a population of less than 1,000,000, 
        including those in non-metropolitan areas, after October 1, 2003, will 
        receive an inpatient hospital base payment rate that is 1.6 percent 
        lower than those serving larger populations;
Whereas 62.3 percent of rural hospitals operated with negative Medicare margins 
        in 2001, and 34 percent of such hospitals had negative total margins and 
        an average Medicare margin of negative 5.7 percent in the year 2000;
Whereas the current Medicare wage index formula harms rural providers' ability 
        to attract and retain health care workers;
Whereas rural areas continue to have problems recruiting and retaining skilled 
        health care professionals in part due to lower Medicare physician 
        payment rates in rural areas than in urban areas;
Whereas programs, such as the Medicare Incentive Payment Program, designed to 
        enhance the recruitment of physicians to rural underserved areas, have 
        been shown by the General Accounting Office to be ineffective due to 
        administrative obstacles;
Whereas, due to the current Geographic Practice Cost Index, payments to rural 
        Medicare physicians and other health professionals are generally less 
        than such payment rates received by their urban counterparts;
Whereas rural health care providers face significant financial barriers, 
        including lower Medicare reimbursement rates, lower patient volumes, and 
        fewer opportunities to benefit from economies of scale;
Whereas rural health care providers generally purchase supplies, services, and 
        in some instances, labor, based on national markets;
Whereas the 10 percent Medicare add-on payment for rural home health care 
        agencies expired on April 1, 2003, following the October 1, 2002 
        implementation of a 15 percent reduction in Medicare home health 
        payments, causing financial difficulties for agencies, and thus 
        decreasing access for homebound patients; and
Whereas non-metropolitan residents are generally older, disproportionately 
        poorer, report poorer health status, and use more health care services 
        than their respective metropolitan counterparts, yet Medicare 
        expenditures for non-metropolitan beneficiaries are approximately 18.4 
        percent lower than such expenditures for metropolitan beneficiaries: 
        Now, therefore, be it
     Resolved, That the House of Representatives--
            (1) supports payment rates for rural physicians, hospitals, 
        and other health care providers that are adequate, and 
        equitable to their urban counterparts;
            (2) encourages Federal efforts to address the current 
        inequities in Medicare reimbursement rates; and
            (3) encourages Federal efforts to ensure access to quality, 
        affordable health care.
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