August 2005

Priority Issues as Congress Moves Toward Action

With congressional action on appropriations bills and other legislation that will affect health care expected in September, Catholic Health Initiatives’ advocacy staff and market-based leaders are talking with legislators about high-priority issues.

“Congress is in recess during August, so many legislators are available in their home states,” said Colleen Scanlon, RN, JD, senior vice president of advocacy for Catholic Health Initiatives. “We encourage market-based leaders to meet with their legislators and discuss the issues of greatest concern to their organizations.” Issues being addressed by Catholic Health Initiatives’ advocacy staff include: Access and Coverage Medicaid Reform — Prevent reduction in health care coverage, benefits and access for low-income individuals as Congress seeks to cut $10 billion from the Medicaid program. Insist that Medicaid reform be driven by sound public policy, not budgetary goals. Critical Access Hospitals (CAHs) — Allow grandfathered, “necessary provider” CAHs to rebuild facilities more than 250 yards from their current locations without losing CAH status. Seek legislation if Centers for Medicare and Medicaid Services (CMS) does not remove these inappropriate restrictions. Inpatient Rehabilitation — Enact legislation to prevent the CMS from using outdated criteria (75 percent rule) to determine eligibility for payment as an inpatient rehabilitation hospital or unit. The CMS approach will limit patient access to appropriate rehabilitation care. Fair Payment Budget Cuts — Prevent reduction in provider payments under Medicaid or Medicare in Congressional budget reconciliation/deficit reduction legislation. Seek payment updates that recognize increased costs incurred in providing quality care. Rural Hospitals — Expand cost-based Medicare reimbursement to inpatient and outpatient services of rural hospitals with up to 50 acute care beds. For CAHs, provide cost-based reimbursement for post-acute services; reinstate cost-based reimbursement for clinical laboratory services provided to patients not physically present in the hospital. Home Health — Extend for two years the temporary five percent Medicare payment increase for home health services provided in rural areas, which expired April 1, 2005. Workforce Strengthening Nursing Appropriations — Increase funding for nursing workforce development programs by 15 percent, to a total of $175 million, in the fiscal year 2006 appropriations bill for the Departments of Labor, Health and Human Services and Education. More than 80 percent of qualified scholarship/loan applicants are turned away due to lack of funds. Preserving the Ministry Charitable Purpose — Educate legislators on community benefits provided by Catholic Health Initiatives organizations. Avoid inappropriate regulatory and operational burdens on non-profit organizations providing needed health care services to their communities. Moving Toward Action Catholic Health Initiatives’ E-Advocacy Web site contains letters on several of these issues that can be easily customized and sent to legislators. The E-Advocacy site is accessible from Catholic Health Initiatives’ Web site, For more information or assistance with advocacy objectives, contact Marcia Desmond, director of public policy, at; or Colleen Scanlon at colleenscanlon