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NOSORH Conference Call: Stimulus Bill’s impact on Rural Health

NOSORH Conference Call: Stimulus Bill’s impact on Rural Health. Tim Fry timfry@gmail.com March 2nd. Tim Fry, Government Affairs Manager National Rural Health Association Fry@NRHArural.org / 202-639-0550. Agenda for my portion. Quick overview of stimulus package

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NOSORH Conference Call: Stimulus Bill’s impact on Rural Health

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  1. NOSORH Conference Call:Stimulus Bill’s impacton Rural Health Tim Fry timfry@gmail.com March 2nd Tim Fry, Government Affairs Manager National Rural Health AssociationFry@NRHArural.org / 202-639-0550

  2. Agenda for my portion • Quick overview of stimulus package • Medicaid provisions • USDA loans and grants • HIT incentives for rural PPS hospitals and CAHs

  3. The basics of the stimulus • $787 billion package • $1.1b for comp. effect research • Includes rural • Rural broadband • Rural water projects • Prevention and wellness projects

  4. Medicaid Funding • $87 billion to increase FMAP • 10/1/08 – 12/31/10 • 6.2% increase to all states and territories • Bonus formula • Maintain efforts • Continue prompt pay requirements with exceptions (Calif.) Save Medicaid

  5. Additional Medicaid provisions • Temp. DSH increase • FY09 2.5% increase • FY10 2.5% above 09 • After FY10 – 100% • Delay on regulations • Extended case management, provider taxes, school-based administration & transportation services • Added hospital outpatient • June 30, 2009 • Sense of Congress that the Sec. HHS should dump

  6. Rural facility development Grants specific to health Rural development loans $130 million for rural community facility development Translate to well over $1 billion in guaranteed loans for rural facilities, including health care facilities In addition grants through USDA for facilities, including health care • $500m Indian Health Srv • $1b Veterans Admin • $2b Community Health Centers USDA program

  7. HIT Adoption • RHC/FQHC • 30% needy patients • Medicaid cover no more than 85% of IT costs • Eligible providers • Medicare up to 41k • Medicaid, if 30% Medicaid – 85% of IT costs • $2b for grants and office of HIT coord. (Neal) • Incentive payments for meaningful adoption: • CAHs • Depreciation value of Medicare IP % plus 20% • Paid same yr. as becoming meaningful • PPS Hospitals • Base of 2m plus amount per discharge up to 23k • Paid over four year period

  8. CAH Incentives • Depreciation value of Medicare inpatient + charity care • 20% bonus of value • Receive this in the same year as adoption • 2015, if do not adopt, lose $ until only 100% of costs • Pays un-depreciated costs

  9. Rural PPS Formula • $2 million base • Plus per discharge Medicare share + charity cases • Over a four year time period with reduction • Penalties in FY 2015 • All eligible

  10. Stimulus done but…Does this make reform tougher? • Stimulus got contentious • Only 3 Rs voted with President • HIT seen as precursor • But so many challenges and no money…

  11. Thank you!Its been a tremendous opportunity to work with you. Tim Fry, Government Affairs Manager National Rural Health AssociationFry@NRHArural.org / 202-639-0550

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