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Brindisi, Reed and Stefanik Lead Bipartisan Effort To Protect Rural NY Hospitals

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In order to combat the problems faced by rural hospitals, Reps. Anthony Brindisi (NY-22), Tom Reed (NY-23), and Elise Stefanik (NY-21) have introduced the Access for Rural Communities Act (ARC), which would provide a legislative fix to a problem that arose for 16 rural New York hospitals as a result of a 2015 Centers for Medicare and Medicaid Services decision.

Brindisi says that decision “created bureaucratic confusion” and resulted in “recoupment payments being sought by Medicare contractors from the local hospitals.” He says the ARC Act would provide CMS with the authority to fix this problem and help New York rural hospitals stay open.

“Maintaining access to health care for our rural communities is, unfortunately, often times a life or death issue,” Brindisi said. “Congress needs to do everything it can to keep the doors of these rural hospitals open. The ARC Act is a small step to ensuring Upstate New York communities have access to care.”

Text of the bipartisan legislation can be found HERE.


Background:

  • Medicare Volume Decrease Adjustment (VDA) are a lifeline that help Sole Community and Medicare Dependent hospitals maintain core staff and services when these facilities experience a significant decrease in patient volume due to circumstances beyond their control.

  • In good faith, hospitals in Upstate New York applied to National Government Services (NGS), the Medicare contractor for New York and New England,  for VDA payments; were determined to meet all requirements to qualify for an adjustment; and in many cases, were awarded funds.

  • However, new VDA calculation instructions from Centers for Medicare and Medicaid Services (CMS) tied to a 2015 Medicare Administrator ruling(Fairbanks Memorial Hospital) required NGS to re-review all VDA calculations made since 2013.

  • As a result, 16 small rural hospitals in New York have faced or continue to face recoupments that could total $15 to $20 million, with a punitive interest rate of over 9 percent.

 

  • This legislation would provide CMS with the authority to go back and fix the hospital payments in situations like this.

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