Rural Health Improvement Act of 1997

TABLE OF CONTENTS:

Title I: Equalization of Medicare Reimbursement Rates to

Health Maintenance Organizations and Competitive Medical

Plans

Title II: Expansion of Grant Authority to Include Technical

Assistance for Rural Health Networks

Title III: Medicare Rural Primary Care Hospital Program

Title IV: Incentives for Health Professionals to Practice in

Rural Areas

Subtitle A: National Health Service Corps

Subtitle B: Primary Care Services Furnished in Shortage

Areas

Title V: Classification as Rural Referral Centers;

Geographic Reclassification for Disproportionate Share

Payment Adjustment

Title VI: Medicare Payment Methodologies

Title VII: Antitrust

Title VIII: Financing

Rural Health Improvement Act of 1997 - Expresses the sense of the Congress that this Act reflects the dedication of the late U.S. Representative Bill Emerson to ensuring health care access for all rural Americans.

Title I: Equalization of Medicare Reimbursement Rates to Health Maintenance Organizations and Competitive Medical Plans - Amends title XVIII (Medicare) of the Social Security Act (SSA) to revise provisions for payments to health maintenance organizations (HMOs) and competitive medical plans (CMPs) for the stated purpose of equalizing Medicare reimbursement rates to HMOs and CMPs.

(Sec. 102) Expresses the sense of the Congress that HMOs or CMPs in rural areas receiving additional payments as a result of this title should allocate those payments to provide increased health care services to Medicare beneficiaries or to pay for health care service infrastructure needs.

Title II: Expansion of Grant Authority to Include Technical Assistance for Rural Health Networks - Amends the Public Health Service Act to direct the Secretary of Health and Human Services (HHS) to provide technical assistance, directly or through grants or contracts, for the planning, development, and operation of any program or service carried out pursuant to a rural health network under that Act.

Title III: Medicare Rural Primary Care Hospital Program - Replaces the Essential Access Community Hospital Program (EACH) under Medicare with the Medicare Rural Primary Care Hospital Program while continuing payment to designated EACHs, rural primary care hospitals, and certain other medical assistance facilities operated as limited service rural hospitals under a specified demonstration program. Permits agreements between rural primary care hospitals and the Secretary for the use of up to 25 beds for extended care services. Bases payment for inpatient and outpatient rural primary care hospital services on the reasonable costs of the hospital in providing such services. Lengthens from 72 to 96 hours the maximum period of permitted inpatient stay at a rural primary care hospital.

Title IV: Incentives for Health Professionals to Practice in Rural Areas - Subtitle A: National Health Service Corps - Amends the Internal Revenue Code to exclude qualified National Health Service Corps scholarship payments and loan repayments from gross income.

(Sec. 402) Requires the HHS Secretary to report to the Congress on the study being conducted on the criteria for designation of health professional shortage areas and medically underserved areas under the Public Health Service Act.

(Sec. 403) Amends the Public Health Service Act to require the Secretary to give special priority to applications by community rural health networks for the assignment of Corps personnel for providing health services in or to a health professional shortage area.

Subtitle B: Primary Care Services Furnished in Shortage Areas - Amends SSA title XVIII to provide for an increase in the amount of additional Medicare payments for primary care services (currently, physicians' services) furnished in rural shortage areas, and for services that are furnished by a physician assistant, nurse practitioner, or nurse midwife that would be physicians' services if furnished by a physician. Extends such payment for former shortage areas.

Requires carriers to report on services provided.

Title V: Classification of Rural Referral Centers; Geographic Reclassification for Disproportionate Share Payment Adjustment - Amends SSA title XVIII to prohibit denial of a rural referral center's request for reclassification on the basis of comparability of wages. Provides for the continuing treatment of previously designated rural referral centers.

(Sec. 502) Permits Medicare hospital geographic reclassification for purposes of disproportionate share payment adjustments.

Title VI: Medicare Payment Methodologies - Directs the HHS Secretary to implement a methodology based on a specified proposal for making payments under Medicare part B (Supplementary Medical Insurance) for telemedicine services.

Title VII: Antitrust - Expresses the sense of the Congress that: (1) physician and hospital networks in rural areas are working to develop alternative means of providing accessible, affordable, and quality health care services to Americans living and working in rural areas; and (2) the Federal Trade Commission, in conjunction with the Justice Department, should, when implementing antitrust guidelines with respect to physician and hospital networks in rural areas, give special consideration to and provide appropriate relief for such networks.

Title VIII: Financing - Extends certain Medicare secondary payer requirements with respect to end stage renal disease.