Rural Pass-Through Provision included in Newly Introduced Senate Legislation

On October 12, Senators Pat Roberts (R-KS), John Barrasso (R-WY), Kent Conrad (D-ND) and Tom Harkin (D-IA) introduced the “Craig Thomas Rural Hospital and Provider Equity Act of 2011 (R-HoPE).”  This legislation contains ASA supported anesthesia rural pass-through provisions that would increase rural patients’ access to high quality anesthesia services provided by an anesthesiologist.  Legislation containing a similar provision - H.R. 1044, the “Medicare Access to Rural Anesthesiology Act" - was introduced in the House of Representatives earlier this year.  

Medicare normally pays for the services of anesthesia providers using the Medicare Part B fee schedule. However, low Part B payments and low patient volume make retention of anesthesia providers difficult for some rural hospitals.  Under current Medicare policy, certain small rural hospitals may use Medicare Part A funds on a “pass-through” basis to pay for the services of anesthesiologist assistants and nurse anesthetists.  When this policy was created in the 1980s, it did not include a provision that would permit hospitals to use pass-through funds for anesthesiologists. Section 20 of this legislation would resolve this disparity oversight and increase patient access to anesthesiology care in medically underserved areas throughout the United States.