[Congressional Record Volume 150, Number 47 (Tuesday, April 6, 2004)]
[Senate]
[Pages S3792-S3793]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. NELSON of Nebraska (for himself and Mr. Brownback):
  S. 2284. A bill to expand the medicare rural community hospital 
demonstration program to include outpatient services; to the Committee 
on Finance.
  Mr. NELSON of Nebraska. Mr. President, today I introduce legislation 
to continue the relief to six hospitals in Nebraska that have been 
struggling financially under the current Medicare payment structure.
  Local hospitals can best meet the unique needs of rural communities 
which is why I am committed to ensuring that these hospitals have the 
resources they need. Vital services like hospitals are increasingly 
important for the survival of our rural communities. Towns can't 
adequately serve residents--or attract new residents--without access to 
basic services. We need to focus on ensuring that hospitals and other 
vital services have the resources they need, so that communities will 
have the essential services they require.
  Last year, Senator Brownback and I proposed legislation to provide 
cost-based reimbursement for rural community hospitals. Rural Community 
Hospitals (RCH) are hospitals with between 25-50 beds. Those hospitals 
had been adversely affected by Medicare formulas that set rates for 
reimbursement nationwide. These rates did not take into account the 
higher costs of practicing medicine in rural areas as these areas do 
not have the benefits of volume that larger hospitals enjoy. RCHs are 
also too large to qualify for critical access designation given to 
hospitals with fewer than 25 beds.

[[Page S3793]]

  I am pleased that provisions from this legislation were included in 
the Medicare Prescription Drug, Improvement, and Modernization Act of 
2003 as a pilot program. The program provided cost-based reimbursements 
for inpatient services.
  The legislation Senator Brownback and I are introducing today will 
expand the pilot program to cover outpatient services as well. This 
legislation will again address a critical shortcoming in current 
reimbursement practices and help Rural Community Hospitals serve their 
communities and invest in the future of rural health care.
  Six Nebraska hospitals would be affected by expanding the scope of 
the pilot program. Those hospitals are: Beatrice Community Hospital, 
Columbus Community Hospital, McCook Community Hospital, Jennie Melham 
Memorial Medical Center in Broken Bow, Phelps Memorial Health Center in 
Holdrege, and Tri County Hospital in Lexington.
  We made some progress for our rural hospitals by creating the RCH 
pilot program last year. This legislation would expand on that victory 
by ensuring that all Medicare treatments, whether inpatient or 
outpatient, would receive cost-based reimbursement. Expanding this 
program will make a big difference to these hospitals and more 
importantly, the patients they serve.
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