New York Lawmakers Introduce Access for Rural Communities Act to Protect Rural Hospitals

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From the office of Congresswoman Claudia Tenney:

Washington, DC – Representatives Claudia Tenney (NY-22), Antonio Delgado (NY-19), John Katko (NY-24), Tom Reed (NY-23), and Elise Stefanik (NY-21) have introduced the Access for Rural Communities Act (H.R. 3069), a bipartisan bill to support rural hospitals in maintaining operations. Following a 2015 decision made by the Center for Medicare and Medicaid Services (CMS) that retroactively changed how hospitals were to be reimbursed, 16 small rural hospitals throughout New York were suddenly burdened with having to repay Medicare contractors for payments they received years earlier. Because of mistakes made by contractors and arbitrary, retroactive changes by the federal government, New York hospitals now owe between $15 to $20 million. Many of these hospitals are already in need of greater support and assistance.  

“This is fundamentally a question of fairness. Through absolutely no fault of their own, rural hospitals in New York now face a huge financial burden because of arbitrary and retroactive changes made in Washington. This is placing significant strain on our rural hospitals at an already challenging time, which is why I’m fighting to stop it. I thank my colleagues from across New York for joining me in this bipartisan effort to ensure rural hospitals can continue to deliver quality care to our communities,” said Rep. Tenney. “Upstate families need access to more health care options — not less. Due to arbitrary federal changes, many small rural hospitals in upstate New York, including A.O. Fox in Oneonta, are facing a threat to keeping their doors open,” said Rep. Delgado. “I am proud to join this bipartisan effort to support our rural providers. Folks from every zip code deserve quality, convenient, and affordable health care options.” 

“I’m glad to join Republicans and Democrats from New York’s Congressional Delegation to introduce the Access for Rural Communities Act. This bill would provide relief to local rural hospitals including Auburn Community Hospital and Oswego Health, who are being unfairly penalized by a Centers for Medicare and Medicaid Services (CMS) policy requiring retroactive repayments of millions of dollars to Medicare contractors. Many hospitals in our region have already faced significant financial burdens due to the ongoing pandemic. We can’t let these critical facilities falter and our bill would ensure they’re able maintain operations,“ said Rep. Katko. “We care about ensuring the hardworking people throughout rural New York have access to the hospitals and healthcare that they need,” said Rep. Reed. “People should not bear the costs of the failures of bureaucracy, which is what this bill protects against. My hope is those responsible for this failure are ultimately held to account.” “The COVID-19 pandemic has been a sober reminder of how important it is to ensure that our small and rural hospitals are able to provide healthcare services year-round and be ready and prepared to serve their communities when they need it most,” said HANYS President Bea Grause, RN, JD. “As Congresswoman Tenney knows well, erroneous recoupments of Medicare Volume Decrease Adjustment payments have long threatened the viability of rural hospitals across New York state. We applaud Rep. Tenney’s continued commitment to resolving this issue by introducing the Access for Rural Communities Act and we look forward to working together to advance this legislation.”
Background: 

  • Medicare Volume Decrease Adjustment (VDA) is provided to Sole Community hospitals and Medicare Dependent hospitals that experience a significant volume decrease due to circumstances beyond their control and is intended to be used to fund core staff and services necessary for continued operation of said hospital. 
  • 16 New York hospitals applied for the VDA and were awarded funds based on calculations from National Government Services (NGS), a federal government contractor. 
  • However, in 2015, NGS announced they were re-reviewing all VDA calculations made since 2013 based on new instructions from CMS. Two years after hospitals received funds and experienced volume decreases, they were now required to repay all or some of the funds they received. 
  • CMS decided to go after hospitals and retroactively recoup funds based on the new formula and not the formula in place when these funding determinations were made. 
  • This repayment has imposed a devastating financial burden on hospitals that are already suffering from decreased volume and threaten the hospitals ability to continue providing medical care in rural areas.

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