Bill > S2359

This bill, titled the "Craig Thomas Rural Hospital and Provider Equity Act of 2014," aims to improve healthcare access for Medicare beneficiaries in rural areas by amending Title XVIII of the Social Security Act. It proposes several changes, including making Medicare's disproportionate share hospital (DSH) adjustment fairer for rural hospitals, extending and expanding "hold harmless" provisions for hospital outpatient department (HOPD) services to protect certain hospitals from payment reductions, and temporarily improving Medicare inpatient hospital payment adjustments for low-volume hospitals. The bill also seeks to extend Medicare wage index reclassifications for specific rural hospitals, continue Medicare reasonable cost payments for certain clinical diagnostic laboratory tests in rural areas, and remove the isolation test for cost-based ambulance reimbursement for critical access hospitals. Furthermore, it establishes a capital infrastructure revolving loan program for rural entities, extends incentive payment programs for physician scarcity areas, and ensures a floor on Medicare work geographic adjustments. The legislation also recognizes physician assistants as attending physicians for hospice patients, improves care planning for home health services, enhances rural health clinics, and provides a temporary Medicare payment increase for home health services in rural areas. It extends increased Medicare payments for rural ground ambulance services, expands Medicare Part B coverage to include marriage and family therapist and mental health counselor services, and extends payment for the technical component of certain physician pathology services. The bill also aims to facilitate telehealth services across state lines, adjust Medicare Part A payment for anesthesiologist services in certain rural hospitals, and temporarily set a floor on the practice expense geographic index for services in rural areas. Finally, it revises the standards for designating sole community hospitals, addresses Medicare's treatment of standby and on-call time for certified registered nurse anesthetist (CRNA) services, supports State Offices of Rural Health, removes a physician certification requirement for inpatient critical access hospital services, and extends an enforcement instruction regarding supervision requirements for outpatient therapeutic services in critical access and small rural hospitals.