WASHINGTON, D.C. – Congresswoman Terri Sewell (D-AL) and Congressman Adrian Smith (R-NE), senior members of the House Ways and Means Committee and representatives of rural congressional districts, introduced two bills to improve rural access to healthcare this week. 

H.R. 1041, the Critical Access Hospital Relief Act, will repeal Medicare’s 96-hour rule, which requires a medical facility to either discharge or transfer a patient within four days of admittance. This arbitrary deadline amounts to an undue burden on both hospitals and patients in rural areas where hospitals are typically more distant from one another, forcing a choice between early discharge and a long, expensive transfer. While the Centers for Medicare and Medicaid Services (CMS) has temporarily addressed this issue through rulemaking, H.R. 1041 would ensure it is addressed permanently.

H.R. 1052, the Physician Assistant Direct Payment Act, will allow physician assistants to be directly compensated by Medicare in order to expand their role as medical providers in underserved communities. At present, physician assistants are the only providers allowed to bill Medicare for services rendered, but required to have their payments routed through a third party such as a physician or hospital.

From Representative Sewell:

“We know that access to good primary care results in people living longer, healthier lives, but in many communities across the country, including many in Alabama’s 7th District, medical professional shortages threaten access to quality health care. Our Medicare payment policies must eliminate barriers that stand in the way of our ability to attract qualified medical talent to rural and underserved areas, such as physician assistants,” Sewell said. “Every American should be able to receive the care they need, regardless of where they live, but the 96-hour rule disproportionately threatens access to health care for Americans living in rural areas, like my constituents serviced by Choctaw General Critical Access Hospital, and severely affects Critical Access Hospitals’ ability to operate. I look forward to working with Rep. Smith to advance these common sense proposals.”  
From Representative Smith:

“I thank Rep. Sewell for joining me to introduce these bills whose goal is to improve access to healthcare in rural areas like Nebraska’s Third District and Alabama’s Seventh District. Rural Americans are frequently left out of the debate in Washington and it’s imperative we continue to fight for their best interests. The repeal of Medicare’s 96-hour rule and allowing physician assistants to be paid directly by Medicare are two great examples of ensuring rural Americans receive better care.”