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C019 054 016 All.Pdf This document is from the collections at the Dole Archives, University of Kansas XEROX TELEObPIER 295 ; ??-??-??; ??: ?? ??http://dolearchives.ku.edu; 2022243163 ~ # 1 {" I -----· . ~- - ---- ·-- , ~ •. f·. TALKINQ POINTS RURAL KOSPt!ALS DEmtBER 1999 The rural ho1pitals will receive a sub1tanti1l incre111 in payment rates under the new prospective paynllnt 1y1t1.1 bl;innin; ( 1/1/90. Hoepitala having a disproportionate 1hare of iow incoaMt patienta with either greater than 100 bede or eole connunity ·-·· ~ • f hospital status will olso receive a higher r•imburaement rate ; with the required occupancy percentage reduced frO.ll'l 45• to 30'· .. ). A board will be establi•hed in HHS to addr••• reclaasif ication of hospitals geographic statue and specific applicable payment rate• for each rural ho•pital if warranted. Hospitals having aole community hospital •tatua will continue with that designation under the prospecti~e paynlent system with the neceeeary adjuatmenta to fully compensate for any ~xed coat. Sole community hospitals will recover 100 perca~t of their capital related coats for inpatient hospital aervic••· Medicare-dependent, small rural hoapitala, having l••• than 100 beds, will receive the greater of paY1lent rates calculated by the Secretary's etaff usino a variety of factor•. Any lo•••• incurred due to circumetancee beyond the control of the ho•pital :'' and in excess of 5\ reduction in utilization will be fully 1-: t. reimburaable. t. r.' Health 1ervice1 for rural residents can be enhanced through the exploration of programs e1tabliehed under OBRA'891 a. B••ential Access Conununity Ho•pital Programs encourage states to e1tablish a rural health plan includinq componente to ., .. address reqionalization, rural health networks, I. ( teleconununication, transportation and 24-hour• emergency medical 11ervices. b. Regional Referral Centers deai;nationa being extended for three yeare. e. Rural primary care hoepital de•iqnation has broader criteria& for designation including that inpatient care can be provided by phy•ician'a eseietant or nurse practitiQner, •ubject to phy1iclan oversight. Rural hospitals may u•e giant~ t9 finance ~~ coat incurred. in converting to a rural primary care hoepital, ••••ntial acce•• community ho1pital or .in becomin9 part of a rural health network be directed to support phy•iciana ~. Financial r••ources will >. paraprofe11ional11 and physicians-in-training develop clinical ! ekill1 in rural areae · PHYSICIANS PBBS ~:': Fee discrepancies between surgical and primary ca.re f·,. 11peeialist1 will be narrowed by the phase-in of the new '·~. Resource-Based Relative Value Scale. atartin9. '92. Over priced [. procedur es , radiology and aneathesiolowr ••rvlce1 a• well a• other services will be adjusted to come into agreement with th• Resource-Based Relative Value Seal• while currently eatabliehin9 a medical volume performance 1tandard for phy•ician fees. NURSE PRACTITIONERS and NON-PHYSICIAR PROVIDlltS ( Services by these profe11ional1, including nurse midwiv•• and clinical nurse specialists, will be covered and paid to the institution of employment. Mental health ••rvices by clinic•l psyeholo;iata or clinical social workers will C.ontinue to be eei~lnq~ reimbureed with removal of the $1, 100 .. " · . ... .. -- -:-. <· ~ >- ,... ·.. ~ "'"·'. ':: '-.! ,.. Page 1 of 8 . ·;~·· • JI. This document is from the collections at the Dole Archives, University of Kansas Tr.. "-' XEROX TELECOP IER 295 ??- ??-??; ??: ?? ??;http://dolearchives.ku.edu 2022243163 -t -----... ...... ...---- · -~-----~~ ~ · · ~.. I •" I ".' , • ~ :-"4i ' ~ .:- ~ ­ •) / Rural Health Provi~iuns .' . '' .. ~. •,. ·• ; ;' ,~~¥"-"· ' • ;; ~~'. : -~;~· i:i.~i·~: .· ·. +. :~:~·~: - ~:. -- 0 l·~nrY.et baGket plus 3 pereont updeltt~ fdctor t·or . " f- rural hospitals has effect of rcduc~n9 th~ 12 l' p~rcent differential in bnsic urban and rur~l rates to about 8 percent. I , 1. 0 Secretary is required to develop a legi•letive I '.' propo1al to phase-out tho ••parat• payment rates by .... I. 1995. .· .• ' .. ~ !. .. ·•: . .. ··· .. ' 0 Eliqibility criteria for aole com=u~ity ho•p1tal•~ i• expanded1 paYJlent fer th••• iaolated ·· pravi'dere""· will be at lOOt Of the hi9heat ot the Pederal PPS rate, th• currant 1982 b.a•• year ho•pital-•peci:tic rate, or a hoapital-•p•ci!io -rate computed us~n9 1987 dat.a. · .i 0 until the tran•ition to a ainql• rate beqin•, •mall Medioare dep.n4•nt •riir•l ' ho•pital• -•r• ~1~9~~1• t~r. :: ... ~ : / . paym•nt under th• new rul•• tor •ole cOJUlunlty · hospital•. Th••• ar• ho•pital• with l••• than 100 beds an4 at l•&•t a 6ot Medicare caaeload. .. 0 Payment a~ju•tment• aro inor••••d for ru~al · ho•pital9 that ••rv• a hi9h pt'oportion of l.ow- incom• patient•. 'l'he threshold for increlsed ' paymente ia low•r•d from 45 percent ·to JO · percent. ·~ .. 0 The t;109raphic Cl•••if ication R•view Board ia ••tabli•h•d, · Th• Seor•ta.ry develop 9uidelin•• to be u•ed by th• Board to r•vi•v requ•ats by hospital• tor a chflnge .in 9a09raphic u •c1•••1f. idat1on.- ".·· ··i · ·' · ·· · ·· : "v ,. ' I ' ~ti ,II.' ! ·:, ·', ' I r ' ,. •, . o ·.• · ' Fund~cz · ~· ~ P·~·a -~'. ~~~ :.~ r~•n~ : p~;••• l •ll•~~ing .. ~;.,., rural -. ho•pit.II*''f ,~ ·} ~• .,.•• nt~tl Adoess Co•~ tI '· Hospital, pto;rqj~~~, establi•h•d, · i~erea••d · f\!nd nf for l:.'Ural· heal~ :-.. iC•~• : ..~ron•ition gr:.anta -i• ~· .. · authorizad at '(j,Oi,;;Jiaillion), llnd ·the rural.: b&llth · medical educatfo~ demonstration projAct i•·axpanded from four 1:tatet1 .. to ten, . : _ -' ,"•, .. ·:•t ·.. ,, .,,.· ·,·: . -. .-. ···a:.:... -· ' .;• .·. ; ; ~it~"f:~t~li,:i •..· ·.::, ;.. ·. : ~.: ' . •;·~ · ~ ~ ·. i'' ·., ·,, ; . ~ ·. ,, ,. \ . ' ... ,. ~ . " :-: .. _.... r_,, ''.':: . .. ~ .. ~· . ' ./:r~ . ,.J •. _:. -~ • Page 2 of 8 This document is from the collections at the Dole Archives, University of Kansas http://dolearchives.ku.edu ? ?- ??-??·~? · ?? ??· 334 ~ # 2 XEROX TELECOPIER 295 '' • • '•I • o • • ''I 6 AP 01-09-90 10:08 EST 92 LINES BC-PAN--Kansas Patterns, Adv13 - 14,870< For release Weekend Editions, Jan. 13-14, and thereafter< AP KANSAS PANORAMA< By BARRY MASSEY= Associated Press Writer= WASHINGTON (AP) Senate Minority Leader Bob Dole emerged as one of President Bush 1 s mos~ reliable supporters in 1989, according to a new voting study that suggests the Kansan has shelved any differences with his former rival left from the 1988 campaign. The analysis of votes in the House and Senate during the first session of the lOlst Congress found that Dole backed Bush 94 percent of the time last year on votes in which the president had a clear position. Two other GOP senators had similar scores, but none were higher. Sen. Nancy Kassebaum, R-Kan., supported the president 85 percent of the time last year. The study by Congressional Quarterly, an independent Washington journal that has followed congressional votin9 for more than 40 years, examined 101 roll calls in the Senate and 86 recorded voted in the House. The annual voting analysis is considered by political scientists as one of the best yardsticks of trends of relations between Congress and the White House. Traditionally, the GOP leader in the House and Senate is responsible for advancing and defending a Republican president's legislative goals. As such, Dole would be expected to serve as one of the most eonsistent presidential supporters in Congress. Bu~ the rivalry between Dole and Bush in the 1988 presidential campaign led many political observers to wonder whether the two men would have a smooth working relationship in 1989 or whether Dole might walk an independent line. As it turned out, Dole proved to be a stronger supporter of Eush during his first year in office than the Kansan was for President Reagan in his initial year in 1981. Dole wasn't the GOP leader in 1981, hut was the chairman of a key Senate tax-writing committee. Dole supported Reagan 84 percent of the time in 1981. Dole's highest presidential support score during the Reagan administration came in 1985 and 1986 1 92 percent, when the Kansan served as majority leader in the Senate. In 1998, Reagan's final year, Dole backed the president 68 percent of the time. Walt Riker, a spokesman for Dole, said the senator's support for Bush reflected the Kansan's leadership post and he downplayed suggestions that it showed the two had overcome their campaign rivalry. ··Lv eryone has tried to make that case ever since Bush has been 1 sworn in, ' said Riker. ''Dole said over and over before election day that it was over and that it was his job as Senate leader to make George Bush a great president. He has more than kept his word. He had no intention of going back to Capitol Hill and being a Bush antagonist.'' Kassebaum's presidential support during Bush's first year also was greater than during Reagan's inaugural year, when she backed Reagan Bl percent of the time. Overall, Congressional Quarterly found that Bush won 63 percent of the votes on which he took a position in 1989, which was lower than any other first-year president other than Gerald Ford, who had a 58.2 percent win-loss ~ecord in Congress in 1974. Bush did better in the Senate, winning 73 percent of the time in which he had staked out a p9~~·•in1 H; Win ~fl &rirrirnt nf thi t1m1 in thi wnnrn Page 3 of 8 This document is from the collections at the Dole Archives, University of Kansas http://dolearchives.ku.edu XER OX TELECOPIER 295 ??-??-??;??:?? ??; 334 ~ # 3 Among Kansans in the House, Rep. Pat Roberts, a Dodge City Republican, was the strongest presidential supporter last year, siding with Bush 79 percent of the time. That was more than Roberts did during Reagan's first year, when the Kansan supported the president 67 pe~cent of the time. In 1988, Roberts backed Reagan on 62 percent of the votes testing the president ' s position. Rep. Bob Whittaker, an Augusta Republican, had a 76 percent presidential support score in 1989. That compared with 70 percent in 1981 during Reagan's first year and 61 prcent in 1988, Reagan's last yea:c: in office.
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