The Government Shuts Down Over Funding Bill
Last night at midnight, the United States Government shut down after the Senate failed to pass a Continuing Resolution (CR) to fund the government through February 16. The House of Representatives had passed the CR in a party line vote the day before, sending the bill to the Senate, where Members were unable to cross the 60-vote threshold necessary to pass the legislation.
NRHA’s Concerns with the Failed CR
Congress has now failed again to act to fund important rural health care programs designed to provide necessary access to care for millions of rural Americans. NRHA is pleased that the failed stopgap measure (the fourth since the beginning of the fiscal year in October) included a six-year extension of the Children's Health Insurance Program (CHIP), a bipartisan program that provides health insurance to children in low income families and pregnant women. We were disappointed to see that this bill did nothing to protect the rural hospitals rural children, families, and the elderly need in order to access local, affordable, quality care.
Rural Medicare Extenders are essential programs, designed by Congress to maintain vital local access to health care in rural communities. The failure to extend these programs comes at a time when these hospitals have already faced a number of payment reductions implemented by Congress and the threat of additional cuts including a growing sequester. These rural programs were designed by Congress to ensure rural hospitals were able to continue to provide quality care in rural America.
The rural extenders include Medicare Dependent Hospitals, Low-Volume Hospital adjustments, rural ambulance payments, Medicare Therapy Caps, and the geographic index floor under the Medicare physician fee schedule. We are already seeing the effects Congressional inaction is having on the future of these programs. A recent Politico report announced that CMS will stop processing therapy claims without the reauthorization of Medicare extenders. According to Politico, "the frailest seniors are expected to hit Medicare's limit starting later this month." For now, CMS is not holding claims on other Medicare extenders.
What the Shutdown Means for Rural Hospitals
We still have hope that Members of Congress will include funding for CHIP and Rural Medicare Extenders in the next CR or final spending package. We have reason to believe that Medicare payments will continue as usual (excluding the previously mentioned therapy claims) during the government shutdown. Medicare did not stop payments for hospitals and physicians during the last government shutdown, which lasted five days from October 1, to October 17, 2013. The Affordable Care Act (ACA) will continue, as will Medicaid programs. The only programs that could be stopped temporarily are those that are considered “nonessential” which includes the Health Resources and Services Administration’s payments for the Children’s Hospital Graduate Medical Education (GME) Program and Vaccine Injury Compensation Claims. The Centers for Disease Control and Prevention (CDC) may be unable to support programs and activities moving forward.
As the shutdown continues, NRHA will update the blog with any additional information.