Trump Administration Adopts Tester’s Legislation to Bring More Doctors to Rural Hospitals

The Centers for Medicare and Medicaid Services propose new policy based on Tester’s Restoring Rural Residencies Act to bring more doctors to rural America; Montana is home to 48 Critical Access Hospitals

(U.S. Senate) – In an effort to address doctor shortages across rural America, the Centers for Medicaid and Medicare Services (CMS) have recommended a new policy based on U.S. Senator Jon Tester’s Restoring Rural Residencies Act.

The new policy would allow Medicare to financially support residency rotations at rural hospitals, increasing the number of doctors training in rural settings and encouraging more medical professionals to practice in rural communities.

“If we want more doctors to practice in rural areas, we need to train them in rural areas,” Tester said. “That’s why I’ve pushed so hard to eliminate the roadblocks preventing residents from training in rural hospitals. Thankfully, the Centers for Medicare and Medicaid Services agree. This proposed change is a huge step towards bringing more doctors to rural hospitals across Montana.”

Montana is home to 48 Critical Access Hospitals, which are hospitals located in rural and particularly remote areas of the country with fewer than 25 inpatient beds. However, current regulations prohibit Medicare from funding residents’ training time at Critical Access Hospitals, significantly limiting recruitment and training efforts in rural states like Montana.

Tester first introduced the Restoring Rural Residencies Act one month after hosting his inaugural Rural Health Summit in May of 2016. The Summit brought together over 100 rural health care providers, federal and state policy makers, and medical professionals to discuss the health care challenges facing providers and patients in rural Montana.

The group determined that recruiting and retaining medical professionals in rural communities was the biggest challenge facing health care providers throughout the state. As a result, Tester drafted and introduced the Restoring Rural Residencies Act to help bring more doctors to rural communities by making it easier for medical residents to train at Critical Access Hospitals.

At the same time, Tester was also pressing CMS to adopt this policy on its own, sending multiple letters to CMS Administrator Seema Verma urging her to repeal the prohibition on Medicare funding for residency rotations at Critical Access Hospitals. As a member of the Senate Appropriations Committee, Tester also secured a provision in this year’s budget bill that directed CMS to reconsider this prohibition and support residency training in rural hospitals.

Even though CMS has announced this rule change, there still needs to be a 60-day public comment period before it can be finalized. That’s why Tester recently sent a letter to Administrator Verma urging CMS to make the rule final. He also reintroduced the Restoring Rural Residencies Act to ensure these changes remain in place throughout future Administrations.

“I applaud your attention to the needs of rural America… and urge you to finalize this regulation,” Tester wrote to Verma. “The rural communities that are home to CAHs across the country and in Montana suffer from serious shortages of physicians. Physicians tend to practice where they train, so training more physicians in rural settings and CAHs is the only way this growing shortfall can be addressed… I look forward to working with you to bring more physicians to rural communities across the nation.”

Tester’s efforts have been praised by Montana health care providers and educators:

“Billings Clinic believes that rotations at rural critical access hospitals are essential to increase the likelihood that new physicians would consider a rural practice location,” said Dr. Virginia Mohl, Medical Director of Education at Billings Clinics. “Living in a small town, residents gain important understanding of what it means to practice medicine in rural communities. This not only allows them to understand the skills they will need to be successful, but helps the residents to build relationships locally. This combination of confidence and relationship increases the likelihood that they will chose to practice and stay there. We are excited that through the efforts of Senator Tester, CMS recognizes the importance of allowing flexibility around the funding mechanisms of these rotations.”

“The proposed rule changes for Medicare reimbursement for medical residents at Critical Access Hospitals would be a huge win for rural Montanans and rural Americans in general. The current Medicare reimbursement rules disadvantage resident training in rural areas,” said Dr. Jay Erickson, Assistant Dean of the Montana WWAMI Clinical Office. “Senator Tester and his staff have been long time advocates to change these rules. The unequal distribution of physicians in rural vs. urban areas is partly driven by a lack of rural training opportunities for medical residents. The proposed Medicare rule changes will help improve access to health care for all Montanans and especially those living in rural and underserved areas.”

Read Tester’s letter to CMS Administrator Verma HERE.

Members of the public can comment on the rule through June 24, 2019 HERE.

Read more about Tester’s efforts to make health care more accessible HERE.