Agency Rule Finalizes Tester’s Effort to Bring Doctors to Rural Areas

Provisions of Senator’s legislation to bring training physicians to rural areas were included in last year’s omnibus government spending bill

After a years-long push from U.S. Senator Jon Tester, the Centers for Medicaid and Medicare Services (CMS) announced its final rule for 1,000 Medicare funded residency slots and new polices that will bring more doctors to train and work in rural communities that are in desperate need of medical professionals, particularly after 21 months of the coronavirus pandemic.

Tester secured inclusion of portions of his Rural Physician Workforce Production Act of 2019, which prioritized residency slots in rural areas, in the Consolidated Appropriations Act of 2021.

“The bottom line is that if we want to lower health care costs across Montana, we need more doctors to practice in rural areas, and the best way to get them here is to train them here,” said Tester. “I’m proud to have worked to secure these 1,000 slots for physicians to train in across the country, and I’m glad CMS recognized the urgent need in releasing this rule so we can get more rural health care providers to Montana communities as quickly as possible. This is a huge step in the right direction, and I’m going to keep fighting to increase access and lower health care costs for Montanans in every corner of our state.”

The CMS final rule establishes policies to distribute 1,000 new Medicare-funded physician residency slots to qualifying rural hospitals, phasing in 200 slots per year over five years. The first round of slots will be announced in January 2023. It also implements policies to further promote increasing training in rural areas and increasing graduate medical education payments to hospitals meeting certain criteria.

The final rule with comment period can be viewed here: https://www.federalregister.gov/public-inspection/current

One of the greatest indicators of where a doctor will practice is the location of their residency, but some rural hospitals can’t afford to take on new residents, despite need. Tester reintroduced the remaining portions of his Rural Physician Workforce Production Act of 2021 earlier this year to continue to address the geographic misdistribution of physicians across the U.S. stemming from the current structure of the Medicare-funded graduate medical education (GME). The updated bill lifts the current caps on Medicare reimbursement payments to rural hospitals that cover the cost of taking on residents, eliminating the serious disadvantage that rural hospitals face when recruiting new medical professionals.

The bill also allows Medicare to reimburse urban hospitals that send residents to train at rural health care facilities during a resident rotation, and it establishes a per resident payment initiative to ensure rural hospitals have the resources to bring on additional residents.

Tester’s Rural Physician Workforce Production Act of 2021 is supported by the Council of Academic Family Medicine, the American Academy of Family Physicians, the National Rural Health Association, and the American Association of Colleges of Osteopathic Medicine.

Tester has fought relentlessly to improve access to health care in rural Montana by training more providers to work in frontier communities and making sure hospitals in those communities have the resources they need. He voted in support of the Fiscal Year 2021 omnibus that extended mandatory funding for the Teaching Health Center Graduate Medical Education program through FY2023, the longest reauthorization of funding for this program to train medical residents in community health centers since 2010.

Tester also authored the Restoring Rural Residencies Act in 2016 after hosting a Rural Health Summit that brought together more than 100 health care professionals and policy-makers to discuss challenges facing health care providers in Montana. This bill would allow rural hospitals to bill for time residents spend training at their sites. The previous Administration finalized a policy change to allow hospitals to receive reimbursement for residents’ training time based on Tester’s proposal.