[Congressional Record (Bound Edition), Volume 152 (2006), Part 8]
[Senate]
[Pages 11154-11155]
[From the U.S. Government Publishing Office, www.gpo.gov]




                 RURAL HOSPITAL AND PROVIDER EQUITY ACT

  Mr. THUNE. Mr. President, I rise today to emphasize the importance of 
enacting into law S. 3500, the Rural Hospital and Provider Equity Act 
of 2006. I would also like to thank the chairman of the Senate Rural 
Health Caucus, Senator Thomas, along with Senators Roberts, Conrad, and 
Harkin, for taking the lead on this important piece of legislation.
  There should be no difference between the quality of care that my 
constituents in South Dakota receive and constituents in urban States 
such as New York receive. Cancer, diabetes, and other diseases do not 
discriminate between people in rural or urban areas and there should be 
no discrimination between the health care services available in Lemmon, 
SD, and health care services available in New York City.
  The Rural Hospital and Provider Equity Act extends and builds upon 
the important rural equity provisions included in the Medicare 
Modernization Act. These provisions can mean the difference between 
traveling 5 miles to the Wagner Community Memorial Hospital or 110 
miles to Avera McKennan Hospital in Sioux Falls. These provisions--in 
more graphic terms--can mean the difference between a fatal heart 
attack and the successful stabilization of a heart attack patient.
  In order to give a better picture of the benefits of this 
legislation, I would like to tell you a little bit about the challenges 
of ensuring health care access in South Dakota. My State has 66 
counties and an average of 9.9 persons per square mile. The national 
average for individuals per square mile is 79.6.
  Of these 66 counties, 44 are classified as medically underserved 
areas, areas that have insufficient health resources, manpower, or 
facilities to meet the medical needs of the population. The sheer 
vastness of South Dakota poses significant challenges in meeting the 
health care needs of our population. The Rural Hospital and Provider 
Equity Act includes hospital, physician, home health, ambulance, and 
telehealth provisions that can make the

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distances of South Dakota more manageable and give my constituents 
access to the quality health care they deserve.
  This legislation contains many provisions that will allow critical 
access and sole community hospitals, as well as rural doctors, to 
continue providing services to individuals who need it most, I would 
also like to highlight the telehealth provisions included in this bill 
that would continue serving rural beneficiaries and expand access to 
the type of care provided in more urban areas.
  Telehealth uses telecommunications and information technologies to 
provide health care services at a distance. It provides individuals in 
remote underserved areas access to specialists and other health care 
providers through the use of technology. Additionally, the practice of 
telehealth brings medicine to people--people who live in medically 
underserved areas and people who are too frail or too ill to leave the 
comfort of their homes.
  Section 19 of the Rural Hospital and Provider Equity Act requires the 
Secretary of the Department of Health and Human Services to create 
demonstration projects that would encourage home health agencies to 
utilize remote monitoring technology. Utilizing technology in the home 
health setting would reduce the number of visits by home health aides 
while still providing quality care.
  Each demonstration project is required to include a performance 
target for the home health agency. This target would be used to 
determine whether the projects are enhancing health outcomes for 
Medicare beneficiaries, as well as saving the program money. Each year, 
the home health agency participating in the pilot would receive an 
incentive payment based on a percentage of the Medicare savings 
realized as a result of the pilot project.
  The demonstration projects would be conducted in both rural and urban 
settings because medically underserved areas exist across the country. 
Three projects, however, are required to be conducted in a State with a 
population of less than 1 million.
  Although numerous studies have praised the ability of telehealth to 
deliver care to individuals in remote areas, it has been continually 
underutilized and hampered by legal, financial, and regulatory 
barriers. Section 20 of the Rural Hospital and Provider Equity Act 
directs the Secretary of the Department of Health and Human Services to 
work with health care stakeholders to adopt provisions allowing for 
multistate practitioner licensure across State lines for the purposes 
of providing telehealth services. This provision is a step in the right 
direction of breaking down the barriers that prevent the adoption of 
telehealth.
  Technology is improving each and every day and health care systems in 
rural America should be taking advantage of technology to provide 
quality health care in remote underserved areas. The telehealth 
provisions included in the Rural Hospital and Provider Equity Act help 
promote the adoption of technology and have the potential to expand 
access to quality health care.
  Individuals living in rural areas like my State of South Dakota 
deserve the same caliber of health care that individuals living in 
urban areas receive. The Medicare Modernization Act was a great start 
to placing rural health care providers on the same level playing field 
with providers located in urban areas. The Rural Hospital and Provider 
Equity Act continues and expands this level playing field, ensuring 
that rural Americans have access to high-quality health care services.
  I thank Senator Thomas for his leadership on this and other rural 
health issues and encourage my colleagues to support this important 
piece of legislation.

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