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Passed: Rural Health Improvement Act of 1987

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Posted (edited)

Ms Boxer introduces with thanks to Mr Packwood




To provide incentives to health care providers serving rural areas, to eliminate the medicare reimbursement differential between hospitals located in rural and urban areas, and for other purposes.


Rural Health Improvement Act of 1987 –

Title I: Tax Provisions

1) Amends the Internal Revenue Code to provide tax credits to physicians, physician assistants, and nurse practitioners for the first five years of their practice in a rural area.

A) Excludes from gross income any payments made on behalf of a taxpayer by the National Health Service Corps Loan Repayment program.

B)  Permits physicians to expense up to $25,000 annually for the purchase of basic equipment used in providing primary care services in rural areas.

Title II: Public Health Service Provisions

2)  Amends the Public Health Service Act to include disadvantaged individuals and minorities and individuals living in, or intending to serve, medically underserved areas among the priority clientele of the National Health Service Corps Scholarship and Loan Repayment programs.

C)  Increases the amount of coverage authorized under the Loan Repayment program. Increases funding for area health education centers.

D)  Targets Public Health Service funds to county health departments for preventive health services.

Title III: Social Security Provisions

3) Amends title XVIII (Medicare) of the Social Security Act to provide for: (1) the elimination, by January 1, 1990, of separate average standardized Medicare payments for large urban, other urban, and rural hospitals; and (2) full implementation, by January 1, 1992, of a resource-based relative value scale for determining Medicare payments to physicians.

E) Covers nurse practitioner services furnished in rural areas. Establishes uniform national payment rates for certified registered nurse anesthetist services.

F) Permits physician assistants to provide Medicare-covered services in rural areas without regard to whether such areas are manpower shortage areas.

G) Sets the Medicare payment for such services at 75 percent of the prevailing charge in the area for the services of participating physicians. Requires that such payments be made on an assignment-related basis. Excludes beneficiaries of such services from copayment requirements.

Title IV: Miscellaneous Provisions

4)Waives the application of antitrust laws against rural hospitals which engage in joint activities that include purchasing, contracting for specified services, and the sharing of personnel.

H) Directs the Secretary of Health and Human Services to determine which Medicare regulations affecting rural hospitals could be made less burdensome without diminishing the quality of care such hospitals provide to Medicare benefits.

Edited by Brady

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The committee will come to order to debate this bill. 48 hours for debate.

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The committee will now vote on this bill. 24 hours for voting.



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