Medicare rule could hurt hospitals

Jefferson County Health Center CEO Deb Cardin told the board of trustees Monday a proposed Medicare rule change could hurt many Iowa hospitals.

Cardin explained the U.S. Department of Health and Human Services has suggested Congress allow Medicare administrators to reconsider whether hospitals, like Jefferson County Health Center, should be in the Critical Access Hospital program because if Medicare excluded hospitals within a set number of miles from another hospital, it could save hundreds of millions of dollars each year.

Of Iowa?s 118 hospitals, 82, including Jefferson County Health Center, have the CAH designation, and those 82 are among the more than 1,300 that have the designation nationwide.

The CAH program began in the 1990s to help rural hospitals by allowing those with the designation to collect at higher rates from Medicare than other hospitals. The extra money has been used to renovate or replace buildings, like the Jefferson County Health Center did, and buy equipment.

Originally, a hospital would have had to be 35 miles from another hospital to qualify for the program. That requirement would have disqualified most Iowa hospitals, but Cardin said a rule change Iowa Sen. Charles Grassley helped push through allowed state governors to make exceptions.

Now the Department of Health and Human Services has proposed Medicare reinstate the 35-mile rule.

It estimates the government and Medicare recipients would save $1.3 million annually for each hospital dropped from the program.

According to The Des Moines Register, 70 Iowa hospitals could be affected by the change, including those in Fairfield, Mount Pleasant and Washington.

Grassley and U.S. Sen. Tom Harkin, also from Iowa, both have said many rural hospitals are almost sure to close without the extra money.

Cardin said the Iowa Hospital Association doubts Congress will approve the change and is confident the Congress members from Iowa and the other affected states will fight any attempt to disqualify large numbers of the hospitals. Grassley, Harkin and 18 other senators have signed a bipartisan letter warning against the cuts.

Cardin told the health center trustees that only Congress can approve a rule change, therefore, the Department of Health and Human Services is trying to get Medicare to influence Congress to make it happen.

?But Medicare isn?t going to,? she said.

Iowa ranks second in the number of CAH facilities; Kansas ranks first with 83. Only Connecticut, Delaware, Maryland, New Jersey and Rhode Island do not have any hospitals in the program.