Today, U.S. Congressman Paul A. Gosar, D.D.S. (AZ-04) announced his co-sponsorship of the Critical Access Hospital Relief Act of 2014 (H.R.3991), legislation that would repeal the 96 hour pre-certification rule, which the Centers for Medicare and Medicaid Services (CMS) recently announced it would begin enforcing.
Rep. Gosar Co-Sponsors Bill to Protect Access to Health Care ‘96 hour pre-certification rule is absurd and jeopardizes the health of anyone living in a rural community’
Today, U.S. Congressman Paul A. Gosar, D.D.S. (AZ-04) announced his co-sponsorship of the Critical Access Hospital Relief Act of 2014 (H.R.3991), legislation that would repeal the 96 hour pre-certification rule, which the Centers for Medicare and Medicaid Services (CMS) recently announced it would begin enforcing. This rule requires physicians at Critical Access Hospitals to pre-certify when a patient is admitted that they do not expect the patient to stay more than 96 hours. If the physician cannot certify this, the patient must be transferred or the hospital will not receive reimbursement from CMS. After his co-sponsorship, Rep. Gosar issued the following statement:
“As a health care provider for 25 years, I know the 96 hour pre-certification rule is absurd and 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. I urge immediate passage of this legislation to prevent the consequences resulting from this potentially lethal decision for folks across rural America.”
BACKGROUND
Critical Access Hospitals are already required, in order to maintain their Critical Access designation, to have an average patient stay of less than 96 hours. Now, however, CMS is enforcing an additional requirement that doctors certify prior to admitting a patient that they do not expect each individual patient’s stay to exceed 96 hours. The legislation 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. 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.
