[Congressional Record Volume 143, Number 149 (Thursday, October 30, 1997)]
[Senate]
[Pages S11493-S11494]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




         MEDICARE FRONTIER HEALTH CLINIC AND CENTER ACT OF 1997

 Mr. THOMAS. Mr. President, I am pleased to join my colleague 
from Alaska, Senator Frank Murkowski (R-AK), in introducing the 
``Medicare Frontier Health Clinic and Center Act of 1997.'' This bill 
will go a long way in assuring rural families have access to emergency 
medical care on a 24-hour basis.
  As cochairman of the Senate Rural Health Caucus, it has been my 
priority to put rural health care at the forefront of any legislative 
package. Included in this year's ``Balanced Budget Act of 1997,'' is a 
comprehensive set of reforms that increases Medicare reimbursement 
rates to midlevel practitioners, improves payment levels to rural 
health plans contracting with Medicare and permits small hospitals to 
stay open even if they do not meet all of the requirements stipulated 
under Medicare's conditions of participation.
  It is this last provision that is particularly beneficial to 
Wyoming's health care community. For the first time, our hospitals will 
be able reconfigure their services and reduce excess bed capacity. The 
new entities will be called ``Critical Access Hospitals'' [CAH's]. They 
will be excused from some of the onerous staffing regulations designed 
with big cities in mind. In addition, they will be reimbursed on a 
reasonable-cost basis, which provides the extra payment needed to 
remain open.
  While the newly established CAH Program goes to great lengths to 
expand medical care in rural America, there is still more to do. That 
is where our bill steps in. The ``Medicare Frontier Health Clinic and 
Center Act,'' permits state certified health clinics in the most 
frontier areas to upgrade to CAH status. This will ensure that remote 
areas of the country will finally have access to hospital services.
  Too often, health care providers are forced to close their doors 
because they cannot contend with low utilization rates, costly 
regulations and inadequate Medicare reimbursement payments. But closing 
a hospital or a medical clinic is not an acceptable option in Wyoming. 
In my State, if a town loses its most important point of service--the 
emergency room--it is typical

[[Page S11494]]

for patients to drive 100 miles or more to the closest tertiary care 
center. An alternative must be available.
  Mr. President, our bill presents communities with a viable option. It 
accommodates different levels of medical care throughout a state while 
providing stabilization services needed in remote areas. It is one in a 
series of measures that the Rural Health Caucus is working on designed 
to improve quality medical care in rural America, and I look forward to 
working with my colleague from Alaska to pass this important piece of 
legislation.

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