Hinson, Scholten Introduce Bipartisan Legislation to End Outdated Medicare Rule, Expand Healthcare in Rural Communities

Washington, D.C. – Congresswoman Ashley Hinson (R-IA-02) and Congresswoman Hillary Scholten (D-MI-03) introduced the bipartisan RNs for Rural Health Act. This legislation will expand and strengthen rural healthcare access by updating Medicare policy to allow registered nurses (RNs) at Rural Health Clinics (RHCs) to facilitate Medicare Annual Wellness Visits (AWVs). This commonsense change ensures adequate Medicare coverage of AWVs at rural health clinics and allows RNs in these clinics to operate under the same standards as those in other settings to deliver high-quality care to more Iowans.

“I’m proud to introduce bipartisan legislation to fix an outdated Medicare policy that limits Iowans’ access to preventative healthcare services. Through providing reimbursement for Annual Wellness Visits performed by RNs at rural health clinics, RNs can serve more Iowans. As I travel around my district, I’ll continue to listen and take back patients’ and providers’ feedback to support the needs of Iowans. This is a commonsense solution that expands healthcare access, reduces costs, and enhances care in rural districts like mine—a win for our communities, medical professionals, and their patients.” – Congresswoman Ashley Hinson

“For too long, rural communities have faced unnecessary barriers to accessing essential preventive care simply because of outdated Medicare billing rules. The RNs for Rural Health Act is a smart, bipartisan solution that will empower rural health clinics to deliver Annual Wellness Visits more efficiently by allowing registered nurses to play a greater role in patient care—just as they already do in other settings. I'm glad to partner with my colleague, Rep. Hinson, on this bill that would level the playing field for rural patients and move us closer to a health care system that prioritizes prevention over crisis treatment." – Congresswoman Hillary Scholten

"Timely access to preventative care is central to our seniors’ health and well-being. The RNs for Rural Health Act would help improve access to these essential services by enabling registered nurses to lead preventive care efforts in Rural Health Clinics as they already do in provider-based clinics, allowing clinicians to dedicate more time and resources to managing patients with complex and acute needs. This bill aligns with Emplify Health’s commitment to delivering high-quality, accessible care that improves outcomes for all patients and communities."  – Patrice Kuennen, Administrator, Emplify Health by Gundersen West Union Hospital

“Currently RNs practicing at rural health clinics (RHCs) cannot bill for Medicare Annual Wellness Visits (AWVs), whereas they are able to in other outpatient settings, creating a disparity in preventive care access for rural beneficiaries. For this reason, the National Rural Health Association (NRHA) is proud to endorse the RNs for Rural Health Act, which would ensure adequate coverage of AWVs at RHCs, and allow RNs to facilitate AWVs in RHCs. We applaud Representatives Hinson and Scholten for supporting RHCs in delivering efficient preventative care and their continued dedication to improving rural health care access." – Alan Morgan, CEO, National Rural Health Association

“Annual Wellness Visits are a critical tool in preventive and primary care delivery for Medicare beneficiaries, however, outdated regulatory barriers in Rural Health Clinics limit the types of health care personnel able to offer such services. We thank Representative Hinson and Representative Scholten for their leadership on this issue - ensuring that RHCs have the same opportunities to offer and be reimbursed for critical wellness services as other outpatient providers." – Sarah Hohman, Director of Government Affairs, National Association of Rural Health Clinics

Background:
Rep. Hinson recently hosted a rural healthcare roundtable at Emplify Health by Gundersen West Union Hospital in Fayette County to share her work and present the concept of the bill to local health providers and community leaders, all of whom applauded the initiative to improve access in rural communities.

Under current Medicare billing rules:

• Medicare reimburses for RNs performing AWVs in provider-based settings but not RHCs.
• Under physician supervision, provider-based clinics can bill for the facility component of an AWV, which includes the RNs time and supplies, through the Hospital Outpatient Prospective Payment System. Provider-based clinics can also bill “incident to” the supervising practitioner’s professional claim through the Physician Fee Schedule.
• RHCs are reimbursed by the All-Inclusive Rate (AIR) for visits, only when AWVs are performed by approved RHC practitioners. Currently, RNs are not included as approved RHC practitioners.

The bill was first covered by Bloomberg Government here. The full text of the bill can be found here.

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