Critical Access Hospitals Lure Unlikely Senate Support

By Tom Bacon

Ordinarily, both Idaho U.S. senators are keen to cut federal spending and influence. But they and six other Republican senators draw the line at cutting back Medicare payments to rural hospitals called "Critical Access Hospitals."

Senators Mike Crapo and Jim Risch have signed on to a letter circulated by Washington Democratic Senator Maria Cantwell urging rejection of a cost-cutting measure in President Obama's 2014 budget proposal. The recommendation would strip the Critical Access designation from two-thirds of the nation's rural hospitals, including 38 in Washington and 27 in Idaho.

For nearly two decades, Critical Access Hospitals have been paid 101-percent of what they say it costs them to provide services to rural residents. Typical Medicare hospitals in more urban areas are paid about 93-percent of such costs. But the Medicare Office of Inspector General found that two-thirds of small hospitals getting the extra money aren't really all that remote at all.

About 1,300 of the nation's critical access hospitals were certified under an old rule which allowed states to exempt them from requirements that they be a certain number of miles from the nearest hospital. But Cantwell, Crapo and Risch said the critical access facilities are vital in providing healthcare, and that they're robust economic engines to boot. Cantwell said hospitals which could be hurt in Washington state under the proposed budget cuts include Lake Chelan Hospital and the Pullman Regional Hospital.
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