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Brady Opening Statement: Rural Health Disparities

July 28, 2015

WASHINGTON, DC — Today, House Ways and Means Health Subcommittee Chairman Kevin Brady (R-TX) delivered the following opening statement during a hearing on rural health care disparities created by Medicare regulations.

“Good morning. Welcome to today’s hearing on rural health disparities. This is an important issue for all of us, but the challenges facing rural beneficiaries and providers are especially evident to those of us who represent districts that aren’t completely urban.

“Our constituents are seeing first hand the difficulties caused by overregulation and bureaucracy. And it is our rural neighbors who pay the price when it comes to access.

“Take for instance, the so-called ’96-hour rule.’ Critical access hospitals are a critical piece of rural health infrastructure. Doctors at critical access hospitals have to certify that it is reasonable that an individual would be discharged or transferred to a hospital within 96 hours of being admitted to a critical access hospital. That arbitrary cut-off doesn’t always match the medical reality for patients seeking treatment at facilities near their homes.

“I have personally heard from St. Joseph’s, a critical access hospital in my district, on the problems with the 96-hour rule.

“Or consider the rules related to physician supervision. Physician shortages are a reality in many parts of this country. Rules that change the way routine therapeutic services are handled in rural areas or rules that bar physician assistants from providing services, like hospice, disrupt access and the continuity of care for rural beneficiaries.

“We can do better, we must do better, and we will do better. We should provide relief for all our hospitals and providers from overly burdensome regulations and bureaucracies. There is no better place to start that process than with our rural hospitals.

“There is much to be done. And today we are lucky to hear firsthand accounts from providers serving rural communities.

“First, we have Shannon Sorenson, CEO of Brown County Hospital in Ainsworth, Nebraska and a constituent of Mr. Smith’s. Next, we have Tim Joslin, CEO of Community Regional Medical Centers in Fresno, California, a constituent of Mr. Nunes’s.

“Then, we have Carrie Saia, CEO of Holton Community Hospital, a facility located in Congresswoman Jenkins’s hometown in Kansas. Finally, we have Dr. Daniel Dirksen from the University of Arizona. We are very happy to have you here today.

“This is the latest in a series of hearings held by the Health Subcommittee in the wake of the passage of legislation to fix the way Medicare pays our nation’s physicians. Now, I know I mentioned this at our MedAPC hearing last week, but it stands repeating: We are in the midst of a great opportunity to reform how Medicare reimburses hospital and post-acute care providers.

“I hope today we can make progress in understanding the concerns facing those in rural areas.”