WASHINGTON, DC – U.S. Senators Pat Roberts (R-Kan.), and Jim Inhofe (R-Okla.) introduced bipartisan legislation to protect rural Critical Access Hospitals (CAH) and their patients by eliminating the “condition of payment” rule from The Centers for Medicare and Medicaid Services (CMS). This overly burdensome rule requires physicians in rural CAHs to predict and limit a patients’ stay to within 96 hours. The bill has 7 original cosponsors.

“This absurd rule puts arbitrary limits on how many hours patients can stay in critical access hospitals and asks doctors to predict the unknown when admitting a patient. This puts the doctor in a terrible position and damages the all-important doctor patient relationship,” Senator Roberts said. “We need to focus on ensuring rural patients have access to the health system, not come up with bureaucratic ways to make it harder for those patients to get quality care from their doctors based on where they live.”

“Overregulation is one of the major obstacles to maintaining excellence in rural health care facilities in Oklahoma,” Sen. Inhofe said. “I’m proud to cosponsor this legislation that does away with onerous bureaucracy and allows patients to receive the care they need from their doctors.”

The Senators’ bill, the Critical Access Hospital Relief Act of 2019 removes the “condition of payment” for Critical Access Hospitals that requires a physician to certify upon admission that each patient will be discharged or transferred in less than 96 hours.

At issue is whether the hospital can be reimbursed if, for instance, a physician certifies that they expect the patient to be treated and discharged within 96 hours, but the situation changes and the patient must be kept longer.  The physician will be faced with a scenario in which they have failed to meet the terms of their certification. This is likely to lead to premature discharges and readmissions, both of which CMS has taken actions to minimize. In some cases rural patients may be forced to travel to an urban hospital a great distance away.

The bill is cosponsored by 7 cosponsors including Sens. Jon Tester (D-Mont.), John Barrasso (R-Wyo.), Michael Bennet (D-Colo.), Lisa Murkowski (R-Alaska), Tammy Baldwin (D-Wis.), Jim Inhofe (R-Okla.), and Mike Rounds (R-S.D.).

Senator Roberts is a co-chairman of the Senate Rural Health Caucus. He is a senior member of the Senate Finance Committee and a member of the Senate Health, Education, Labor and Pensions Committee.