Schumer says ‘critical access status’ for Medina hospital will result in $1.6 million

File photo by Tom Rivers: U.S. Sen. Charles Schumer speaks to reporters at a news conference on Nov. 19, 2020 outside Medina Memorial Hospital. That conference was about his push for increased Covid testing in Orleans County and other rural areas.

Press Release, U.S. Senate Majority Leader Charles Schumer

U.S. Senate Majority Leader Charles E. Schumer announced that the Centers for Medicare and Medicaid Services (CMS) has heeded his call and proposed to reverse its previous rules change for the eligibility criteria for rural hospitals that put many Upstate New York hospitals at risk of losing their Critical Access Hospital (CAH) status.

Editor’s Note: That status will result in $1.6 million annually for Medina Memorial Hospital (Orleans Community Health), according to Schumer’s office.

The CAH program allows smaller rural providers, like those in the North Country and Southern Tier, with the designation to receive greater federal reimbursements for care to keep these otherwise financially vulnerable rural hospitals in the communities that need them most. Schumer explained that in 2015 the CMS issued a new policy change without going through the proper notice and rulemaking required by law that would enact more restrictive eligibility definitions for the CAH program, costing these rural hospitals millions.

Schumer immediately began leading the fight to maintain CAH status for Upstate’s rural hospitals, sending multiple letters highlighting the issue and the impact it would have on rural residents, and personally called HHS Secretary Xavier Becerra to fix this bureaucratic mistake that could cost thousands of rural family’s critical healthcare services.

Thanks to Schumer’s advocacy, CMS has now proposed to reverse this disastrous policy and clarify the language that would have caused New York’s CAH’s to lose their status, saving hospitals millions and allowing them to maintain their presence in rural communities.

“I promised our rural hospitals that I would not stop fighting until these rules changes were fixed and their Critical Access Hospital designation was ensured,” said Senator Schumer. “Now I am proud to announce that rural communities from the North Country to the Southern Tier can breathe a sigh of relief as these essential healthcare providers will continues to receive the millions in federal reimbursements they need and deserve to keep saving lives.”

Schumer explained that the Critical Access Hospital (CAH) designation was created by the Balanced Budget Act of 1997 to give small rural healthcare providers greater financial reimbursement for servicing Medicare and Medicaid patients, as well as provide other resources, in order to keep vulnerable rural hospitals financially stable.

One factor for CAH eligibility requires that a hospital be a certain distance from another hospital by either a primary or secondary road and provide around-the-clock emergency services. Previously, CMS regulations stated that a CAH hospital must be at least 35 miles from the nearest hospital by “primary road,” defined as any road in an interstate system or a US-numbered highway, or at least 15 miles in areas with mountainous terrain or only “secondary roads.” defined to include single lane state routes.

In 2015, however, CMS issued a memo that changed the definition of primary road to include any road that is in the National Highway System, which would include single lane NYS routes. This significant expansion to language and more restrictive definition of “primary road” if enforced would have led to dozens of CAHs in multiple states, including at least nine in New York, to lose their CAH status and hundreds of millions of dollars of needed funding to keep them in business serving rural patients.

Specifically, if this change were to have been fully enacted and enforced, it would cost Upstate New York hospitals over $35 million a year.

Some of the impacted New York hospitals would have included: Carthage Area Hospital, $9.7 million; Community Memorial Hospital, $4.1 million; Ellenville Regional Hospital, $4.7 million; Gouverneur Hospital, $3.3 million; Lewis County General Hospital, $5.3 million; Margaretville Hospital, $2.4 million; O’Connor Hospital, $3 million; Medina Memorial, $1.6 million; and Soldiers and Sailors Memorial Hospital, $1.4 million.