Statements On Introduced Bills And Joint Resolutions

Floor Speech

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By Mr. DURBIN:

S. 1585. A bill to permit pass-through payment for reasonable costs of certified registered nurse anesthetist services in critical access hospitals notwithstanding the reclassification of such hospitals as urban hospitals, including hospitals located in ``Lugar counties'', and for on-call and standby costs for such services; to the Committee on Finance.

Mr. DURBIN. Mr. President, today I'm introducing the Rural Access to Nurse Anesthesia Services Act to ensure patients in rural communities can access the health care services they need. The bill would restore rural healthcare by making improvements to the Medicare Part A reasonable cost-based, pass-through program for nurse anesthesia services in rural and critical access hospitals.

Throughout the Nation, 1,300 critical access hospitals provide essential health care services to the elderly and medically underserved communities in rural areas. In my State of Illinois, 51 Critical Access Hospitals provide emergency, primary care, and surgery services directly to rural communities, covering over 60 percent of the counties in the State and reaching over 1 million rural residents.

For the majority of Critical Access Hospitals, Certified Registered Nurse Anesthetists are the sole providers of anesthesia services. The nurse anesthetists make it possible for these hospitals to offer surgical, obstetrical, trauma stabilization, interventional diagnostic and pain management capabilities.

Critical Access Hospitals depend on the work of nurse anesthetists to deliver quality care, even while the hospitals are pressed for resources. Because of the limited availability of nurse anesthetists and fewer patients in their rural communities, Critical Access Hospitals do not have anesthesia in the hospital 24/7. They rely on anesthesia and other surgery staff to be on call and available to the hospital within 15 minutes to cover emergency surgery procedures and obstetric services.

As an incentive to continue serving Medicare beneficiaries in rural areas, critical access hospitals were given permission to use reasonable, cost-based funding for anesthesia services performed by nurse anesthetists. However, recent changes in CMS policy have denied Critical Access Hospitals' claims for tens of thousands of dollars each in annual Medicare funding that they had come to rely on. In Illinois, Critical Access Hospitals lost $50,000-$100,000 per hospital.

These hospitals aren't just looking for a handout. Without being able to pay nurse anesthetists, the rural hospitals have to turn away patients whose procedures call for anesthesia. Patients have to travel to the next nearest hospital, which is a terrible option when dealing with trauma stabilization, obstetrical care, or even pain management, particularly for elderly patients.

In addition, despite previously reimbursing Critical Access Hospitals for the costs of having a nurse anesthetist available or on call for emergency services, CMS recently began to deny payments for this service. How is a hospital able to retain the few nurse anesthetists who are available if they can't at least keep them on call?

The Rural Access to Nurse Anesthesia Services Act will enable hospitals to offer the highest quality of care and availability of services to patients of Critical Access Hospitals. For decades, the Medicare Part A reasonable cost based pass-through program has successfully and safely ensured the availability of anesthesia services for Medicare patients in rural areas. Because of the program's success and impact, the Rural Access to Nurse Anesthesia Services Act is supported by the American Association of Nurse Anesthetists and the American Hospital Association. I hope my colleagues will join me in supporting this bill and work to protect anesthesia services for patients in rural communities.

Mr. President, I ask unanimous consent that the text of the bill be printed in the Record.

There being no objection, the text of the bill was ordered to be printed in the Record

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