[Congressional Record (Bound Edition), Volume 153 (2007), Part 18]
[Senate]
[Pages 25905-25906]
[From the U.S. Government Publishing Office, www.gpo.gov]




                 CRITICAL ACCESS HOSPITAL IMPROVEMENTS

  Mr. CONRAD. As the chairman knows, many rural hospitals are facing

[[Page 25906]]

significant financial pressure and are finding it increasingly 
difficult to operate under the Medicare prospective payment system. In 
response, the chairman and I have worked closely to support our rural 
facilities and established the Critical Access Hospital Program in 
1997. This program was designed to help small, rural facilities remain 
financially viable in the face of inadequate Medicare reimbursement, 
and it has been tremendously beneficial to maintaining access to 
hospital care across North Dakota and other rural states.
  Mr. BAUCUS. I share my colleague's support for the Critical Access 
Hospital Program. Like North Dakota, Montana struggles to maintain 
sufficient access to hospital care. The Critical Access Hospital 
Program has been an important component in ensuring that our hospitals 
can remain open and continue to serve Medicare beneficiaries.
  Mr. CONRAD. Despite the successes that have been achieved under the 
Critical Access Hospital Program, changes made as part of the Medicare 
Modernization Act of 2003 have harmed the ability of certain critical 
hospitals, such as St. Joseph's Hospital in Dickinson, ND, to become 
critical access hospitals. It is imperative that flexibility be 
reinstated in the program to allow States to deem hospitals as 
necessary providers and, therefore, eligible for critical access 
hospital status. I have spoken with you about this issue in the past 
and am pleased that you are willing to consider this issue during 
consideration of a Medicare package later in the year.
  Mr. DORGAN. I strongly support reinstating the ability of States to 
deem necessary providers to be critical access hospitals. The Critical 
Access Hospital Program has helped ensure that the doors stay open at 
many hospitals in rural America. Without this program, many Medicare 
beneficiaries in my State would have to drive hours to receive health 
care. I think it is important to give States flexibility to deem 
necessary providers as critical access hospitals and not rely on a one-
size-fits-all definition. If we don't address this issue, I am worried 
that one of our hospitals in western North Dakota, St. Joseph's 
Hospital, may not be able to survive. I appreciate Chairman Baucus' 
commitment to work with us to address this issue and to consider 
modifications to the Critical Access Hospital Program that would allow 
St. Joseph's Hospital in Dickinson, ND, to participate.
  Mr. BAUCUS. I applaud my colleague's efforts on this issue and assure 
you that I am committed to working with you to enact modifications and 
improvements to the Critical Access Hospital Program in Medicare 
legislation later this year that will assist hospitals like St. 
Joseph's.
  Mr. CONRAD. I thank my colleague for his commitment and look forward 
to working with you to craft a reasonable solution that benefits St. 
Joseph's.

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