Hoeven Joins Roberts, Tester, Bipartisan Group to Introduce Bill to Protect Rural Hospitals and Patients

Measure Eliminates Damaging CMS 96 Hour Rule

WASHINGTON – Senator John Hoeven Monday joined Senators Pat Roberts (R-Kan.) and Jon Tester (D-Mont.) to introduce bipartisan legislation to protect rural Critical Access Hospitals (CAH) and their patients by eliminating new “condition of payment” rules from the Centers for Medicare and Medicaid Services (CMS) that require a physician to predict and limit a patients’ stay to within 96 hours. The bill has 13 cosponsors.

“Compelling doctors to predict at the outset that a patient needs to stay in the hospital no longer than 96 hours could result in patients being release before they are fully treated, and then being readmitted because they didn’t get the care they needed in the first place,” Hoeven said. “Doctors need to have the flexibility to do what is in the best interest of their patients.”

“This rule requires doctors to be clairvoyant and predict the unknown at the time of admission instead of focusing on treating a patient to the best of their abilities,” 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 patients in rural areas to get quality care from their doctors.”

“Putting arbitrary limits on how many hours patients can stay in critical access hospitals is dangerous and violates the trust patients put in their doctors and nurses,” Tester said.  “Critical access hospitals play a vital role in providing quality and affordable healthcare in rural communities, and we shouldn't shortchange the care someone receives because of their zip code.”

The Senators’ bill, the Critical Access Hospital Relief Act of 2014, 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 Senators Jim Inhofe (R-Okla.) Dick Durbin (D-Ill.), Mike Enzi (R-Wyo), Tammy Baldwin (D-Wis.), Jerry Moran (R-Kan.), Al Franken (D-Minn.), Chuck Grassley (R-Iowa), Amy Klobuchar (D-Minn.), John Barrasso (R-Wyo.), Deb Fischer (R-Neb.), Susan Collins (R-Maine) and Mike Johanns (R-Neb.).