New York representatives push for more information on rural hospital rule change
Jan. 19—A group of New York's federal representatives, including Rep. Elise M. Stefanik, are continuing to advocate for critical access hospitals despite receiving no response from the U.S. Department of Health and Human Services, which oversees the critical access program.
On Friday, Rep. Stefanik, R-Schuylerville, and five other New York representatives sent a letter to Secretary of Health and Human Services Xavier Becerra, asking for more information on a change to the qualifications for critical access hospitals that could lead to nine New York hospitals losing the higher Medicare reimbursement rates and special grant programs that the program provides.
To receive critical access status, a hospital must be more than 35 miles away from another hospital that provides critical care, and meet other requirements. In rural and mountainous regions, as well as places where only secondary, smaller roads are available, that requirement drops to 15 miles.
In 2015, the Centers for Medicare and Medicaid Services, which is run by HHS, adjusted requirements and changed how it calculates the distance between hospitals, redefining what qualified as a "secondary road." The legislators say the adjustment could put a number of New York's 18 critical access hospitals at risk of losing their designation, and the financial support that comes with it.
In the north country, there are four hospitals qualified as critical access hospitals. Two are up for recertification soon — Lewis County General Hospital in Lowville and Gouverneur Hospital.
The remaining two hospitals — River Hospital in Alexandria Bay and Clifton Fine Hospital in Star Lake — could also be impacted once their recertification date comes. Recertification has been paused during the COVID-19 pandemic, but will recommence once the U.S. declares the public health emergency over.
In their letter Friday, the legislators asked HHS for more information on how the criteria change would impact hospitals nationwide, and if the department has a plan to address the potential closures caused by fewer hospitals being supported the financial crutch.
The group sent a similar letter in June, but received no response.
"We have made several contacts with (the Centers for Medicare and Medicaid Services) and the Department (of HHS) in an effort to address this matter in good faith," the Friday letter reads. "To this point however, we remain disappointed that our efforts, including our letter dated June 8, 2021, have gone unanswered."
Rep. Stefanik and Rep. Antonio R. Delgado, D-Rhinebeck, another signatory on Friday's letter, introduced legislation in 2020, and reintroduced it in 2021, that would require HHS to use the old criteria to recertify hospitals that were initially determined as critical access facilities under the pre-2015 rules. Those bills failed to advance both years.
"North country families depend on rural hospitals to provide lifesaving treatments," Rep. Stefanik said in a press release. "Taking away the designation of Critical Access Hospitals will be harmful to our healthcare system and harmful to north country patients."
Health industry experts are similarly concerned about the rule change. Alan Morgan, chief executive officer of the National Rural Health Association, said in a statement that it is vital for critical access hospitals to retain access to the increased Medicare reimbursements and grants that come with the designation.
"Ensuring that these vital, lifeline hospitals are able to maintain their payment status during and beyond the COVID-19 public health emergency is critical to the wellness of rural Americans," he said. "NRHA continues to urge the Centers for Medicare and Medicaid Services to reconsider their 2015 policy to narrow the eligibility criteria for hospitals to recertify as (critical access hospitals)."
