Simpson and Otter Introduce Bill to Help Rural Residents Get Clinical Lab Services Closer to Home

Simpson and Otter Introduce Bill to Help Rural Residents Get Clinical Lab Services Closer to Home

Washington, D.C. - Patients in Idaho's far-flung rural communities would have better access to the laboratory tests they need, without traveling to a larger community to visit a designated "Critical Access Hospital," under bipartisan legislation from Idaho Congressmen C.L. "Butch" Otter and Mike Simpson.

The Critical Access to Clinical Lab Services Act of 2005 was introduced in the U.S. House of Representatives on Tuesday with 15 cosponsors. Its goal is to clarify Medicare rules for payment of clinical laboratory tests conducted at facilities qualified under the "Critical Access Hospitals" program created by Congress in 1997.

The idea of the program was to ensure that people in isolated rural communities have access to health care. To protect the economic viability of these hospitals - which often are a community's only source of vital health-care services - Congress established cost-based reimbursement for Medicare services they provide, regardless of where the services are provided.

A "clarification" by the agency that administers Medicare changed that policy by specifying that, effective October 1, 2003, hospitals no longer could be reimbursed on an at-cost basis for laboratory services unless patients are "physically present in a critical access hospital" when laboratory specimens are collected. Many critical access hospitals provide laboratory services in rural health clinics and nursing homes in smaller, outlying communities, as well as in home-health settings. However, elimination of cost-based reimbursement makes it financially prohibitive for them to continue offering offsite laboratory tests.

"This change is forcing Medicare beneficiaries to travel to a critical access hospital to have lab work done. That's an expense in time and money that these folks just don't have, and it's unnecessary if the hospital is willing and able to draw specimens at the point of care and take it back for analysis," Congressman Otter said. "We've tried repeatedly to get this policy changed administratively. Now it's time to change the law and stop imposing a burden on patients - especially the sick and elderly - that jeopardizes their access to care."

"Our rural communities should have quality access to care without being required to drive long distances unnecessarily. We should applaud our hospitals for bringing health care directly to the patients in their communities rather than punishing the hospitals with lower reimbursement rates," Congressman Simpson said. "I commend Congressman Otter for introducing this legislation that will allow Idahoans to have access to the quality care they deserve."

http://www.house.gov/apps/list/press/id02_simpson/ottersimpson_clinicallabs.html