Warner & Blunt introduce legislation to amend legislative error, protect rural health clinics

U.S. Sens. Mark R. Warner (D-VA) and Roy Blunt (R-MO) introduced legislation today to prevent further financial instability for rural health clinics and safeguard the care they provide to underserved communities. The bipartisan Strengthening Rural Health Clinics Act of 2021 would make a technical fix to protect existing rural health clinics from a sudden and unexpected Medicare payment rate change that was erroneously brought on by the December 2020 COVID-19 relief bill.

“In the past year, rural health clinics have played an essential role in bringing urgent and lifesaving care to some of our most vulnerable communities. Unfortunately, this crisis has served to further throw these facilities into financial distress,” said Sen. Warner. “By fixing a legislative error, our bill will help avoid further financial volatility and allow rural health clinics in Virginia and across the country to continue serving the communities that need it the most.”

“Many Missourians rely on rural health clinics for affordable, quality care close to home,” said Sen. Blunt. “This bill will fix a technical error to protect these clinics from added financial strain on top of the challenges they’ve faced during the COVID-19 pandemic. I urge our colleagues to join us in supporting the vital role these clinics play in improving health care – and the quality of life – in rural communities.”

The emergency COVID-19 relief bill that was signed into law in December included a provision to reform Medicare payment rates for future rural health clinics. While this provision intended to “grandfather” existing rural health clinics at their current payment rates in order to ensure their financial stability, a technical error ultimately excluded clinics that were established after December 2019. As a result, hundreds of rural health clinics nationwide, and even more clinics that were in the “mid-build” phase, now face serious financial uncertainty. Among these are nearly 30 clinics in Virginia:

Shenandoah Medical Associates Front Royal, VA
Valley Health Family Practice Rutherford Crossing, VA
New Warren Memorial Hospital Campus Front Royal, VA
Carilion Clinic Family Medicine Clifton Forge, VA
Carilion Clinic Internal Medicine Hardy, VA
Carilion Clinic Family Medicine Buena Vista, VA
Carilion Clinic Family Medicine Rocky Mount, VA
Carilion Clinic Family Medicine Buchanan, VA
Carilion Clinic Family Medicine Floyd, VA
Carilion Clinic Family Medicine Rocky Mount, VA
Carilion Clinic Family & Internal Medicine Galax, VA
Carilion Clinic Family & Internal Medicine Martinsville, VA
Carilion Clinic Family Medicine Tazewell, VA
Carilion Clinic Family Medicine Wytheville, VA
Carilion Clinic Family & Internal Medicine Boones Mill, VA
Carilion Clinic Family Medicine Bedford, VA
Carilion Clinic Family Medicine Hillsville, VA
Carilion Clinic Family Medicine Bluefield, VA
Carilion Clinic Family Medicine Raphine, VA
Carilion Clinic Family Medicine Lexington, VA
Carilion Clinic Family Medicine – Westlake Hardy, VA
Volens Family Medicine Nathalie, VA
Clarksville Family Medicine Clarksville, VA
Sentara Obstetrics & Gynecology South Boston, VA
Halifax Pediatrics South Boston, VA
Chase City Family Medicine Chase City, VA
Halifax Family Medicine South Boston, VA

In order to protect these clinics from the chaos associated with a sudden payment rate change, this legislation would amend existing law to grandfather at the 2020 or first-year payment rate any qualified rural health clinic that was in existence, in “mid-build”, or that had either submitted an application or had a binding written agreement with an outside unrelated party for the construction, purchase, lease, or other establishments of such a rural health clinic prior to December 31, 2020.

This legislation has the support of a number of organizations including the National Association of Rural Health Clinics (NARHC), National Rural Health Association (NRHA), Virginia Rural Health Association (VRHA), Virginia Healthcare and Hospital Association, Missouri Hospital Association, Missouri Rural Health Association, West Virginia Hospital Association, Carilion Clinic, Valley Health System, Sentara Healthcare, Forrest General Hospital, Highland Community Hospital, Marion General Hospital, Walthall General Hospital, Jefferson Davis Community Hospital, Pearl River County Hospital, Braden Health, Braden Patient Safety Organization, Mississippi Hospital Association, and McLaren Health Care.

“In December, Congress passed significant and positive payment reforms for rural health clinics,” said Nathan Baugh, Director of Government Affairs for the National Association of Rural Health Clinics. “This legislation will ensure that all rural health clinics in existence at the time the law was changed, as well as those who were in the process of becoming a rural health clinic, are fairly grandfathered into the program.”

“On behalf of Valley Health which serves communities in VA and WVA, I would like to thank Senators Warner and Blunt for introducing this important legislation. Rural health clinics are the lifeblood of healthcare delivery in these rural underserved areas. Ensuring that Rural Health Clinics receive proper reimbursement is critical to their continued sustainability. This legislation addresses the concerns of many across the country that was developing rural clinics in previous years and will go a long way in protecting access to care in these communities which is especially important during the pandemic,” said Mark Nantz, President & CEO of Valley Health System.

“The past year has again reminded us of the critical importance of protecting and strengthening access to health care for all people, including those in rural communities,” said Sean T. Connaughton, President and CEO of Virginia Hospital & Healthcare Association. “This legislation aims to correct an oversight in existing law to ensure the adequacy of Medicare reimbursements for designated health care providers treating patients in underserved rural communities. We appreciate the work of Senator Warner and Senator Blunt in sponsoring the Strengthening Rural Health Clinics Act of 2021 and we are proud to support it.”

“Thank you to Senator Warner for his ongoing efforts to assist citizens in rural areas of the Commonwealth with sustainable and expanded access to affordable, high-quality health care,” said Nancy Howell Agee, President, and CEO of Roanoke-based Carilion Clinic. “Much of Carilion’s service area is rural with an aging population. Our community needs assessments consistently reflect concerns about access to primary and specialty care. Our Rural Health Clinics and expanded digital solutions, including telehealth, help us better serve the health care needs in the region and provide more sustainable access to care. Senator Warner has consistently worked to ensure that health care services are available for our rural citizens to the greatest degree possible. His efforts to help stabilize access to these services through our Rural Health Clinics is important and appreciated.”

A copy of the bill is available here. A one-page summary can be found here.