Arizona Congressman Paul Gosar has agreed to co-sponsor the Critical Access Hospital Relief Act of 2014. The legislation (H.R.3991) would repeal the 96 hour pre-certification rule, which would have a devastating effect on anyone living in rural communities.
The Centers for Medicare and Medicaid Services (CMS) recently announced it would begin enforcing the rule.
When a patient is admitted to a hospital, the rule requires physicians at Critical Access Hospitals to pre-certify that they do not expect the patient to stay more than 96 hours. If the physician cannot certify this, according to Gosar, the patient must be transferred or the hospital will not receive reimbursement from CMS.
Critical Access Hospitals have been required to have an average patient stay of less than 96 hours in order to maintain their Critical Access designation. Under the regime, CMS will now enforce an additional requirement that doctors certify that they do not expect each individual patient’s stay to exceed 96 hours, prior to admitting a patient.
H.R.3991 does not remove the requirement that Critical Access Hospitals maintain an average annual length of stay of 96 hours, nor affect other certification requirements for hospitals, according to Gosar.
Critical Access Hospitals in the 4th District of Arizona include: La Paz Regional Hospital, Parker Indian Health Center and Wickenburg Community Hospital. Critical Access Hospitals must be located more than 35 miles from any other hospital.
After his co-sponsorship, Rep. Gosar issued a statement in which he called the rule “absurd.” Gosar said the rule “jeopardizes the health of anyone living in a rural community. In my district, this threat is all too real, as the nearest hospital in some areas is almost 100 miles away. Folks who are sick and need immediate medical attention shouldn’t be turned away just because the doctor can’t say with absolute certainty they won’t require care for more than 96 hours. Additionally, forcing rural patients to travel further to other hospitals will actually increase travel costs associated with Medicare.”
“This dangerous new guidance, which was created and is enforced by faceless bureaucrats in Washington, interferes with the patient-physician relationship; these bureaucrats aren’t considering what’s best for the patient. This only exacerbates the problems that rural communities already face when it comes to accessing quality care and recruiting high quality physicians. If physicians are no longer reimbursed for providing their services as a result of CMS’ recent decision, then quality doctors will no longer seek employment at Critical Access Hospitals. Furthermore, this new directive could lead to an unnecessary death if an acutely ill patient is turned away,” concluded Gosar.