Tester Introduces Legislation to Bring Back Emergency Services to Rural Communities

Bipartisan, bicameral bill to expand ambulance services in rural, mountainous areas

As a part of his continued work to strengthen rural health care systems and ensure that all Montanans have access to emergency services, U.S. Senator Jon Tester introduced his bipartisan Preserving Emergency Access in Key Sites Act to ensure that Critical Access Hospitals (CAHs) in rural, mountainous areas to be able to operate ambulatory services under a special enhanced Medicare payment model.

After hearing from local leaders in Granite County, Senator Tester worked to create a solution for communities who have seen private companies close down emergency service operations citing an unsustainable financial model.

“Access to high quality, affordable health care is critical to the success of Montana’s rural communities – and folks should be able to count on emergency services regardless of where they live,” said Tester. “Thousands of Montanans use Critical Access Hospitals as a lifelines, and in the more mountainous parts of the state, these hospitals provide the only access to health care for rural communities. Allowing these hospitals in mountainous terrain to provide ambulance and emergency services should be a no brainer, and this bipartisan bill will ensure that they’re fully reimbursed for providing access to life-saving care.”

Rural communities across the country have lost emergency medical services and Montana is no different. This bill allows CAHs to fill the gap and provide the access to care rural communities deserve. CAHs are a unique designation intended for the most rural type of hospital. Currently, CAHs in mountainous areas are not being reimbursed for providing ambulatory services under the enhanced Medicare payment model. This legislation would correct that error and reimburse CAHs for ambulatory services when there is no other ambulatory base within 15 miles of the facility. This would help to ensure these CAHs are not operating at a financial loss or struggling to support the flow or transportation of patients in their hospitals, and more areas of rural Montana would have access to ambulances. 

“Granite County Medical Center has been proudly serving Granite County in Western Montana for more than 70 years, but the current Medicare payment model has made it nearly impossible to provide ambulance services in the community,” said Granite County Medical Center CEO Brian Huso. “Reliable emergency services in rural Montana can be the difference between life and death, and for too long the current system has left Granite County struggling to provide emergency medical services on a consistent basis. Thank you to Senator Tester for listening to our community and working to find a solution that strengthens rural health care.”

The bill also protects CAHs currently located in mountainous areas to ensure they will not lose their designation even if a new facility is constructed within 15 miles. Construction in geographically mountainous areas is difficult and sometimes results in the need for flexibility in mileage requirements to preserve access to care in these rural areas.

Tester has consistently worked across the aisle to increase access to quality and affordable health care in rural America.

Last  year, Tester introduced his Defending Access to Rural Health Care Act to make critical investments in rural health care by enhancing telehealth coverage for rural health clinics and centers, providing targeted regulatory relief for Critical Access Hospitals, and ensuring quality care by expanding incentive programs. Tester’s legislation would also lower costs for rural patients by boosting Medicare co-payments for services received in Critical Access Hospitals. Additionally, Tester re-introduced his bipartisan Rural Physician Workforce Production Act with Senator John Barrasso (R-Wyo.) to incentivize young physicians to build their careers in rural hospitals, and ensure those facilities have the resources they need to recruit and retain doctors for the long haul.

In August, 2022, Tester passed the Inflation Reduction Act which requires Medicare to negotiate drug prices, caps out-of-pocket prescription drug costs for Medicare patients at $2,000/year, caps the cost of insulin for Medicare patients at $35/ month, and extends Affordable Care Act provisions to prevent price hikes for thousands of Montanans. The legislation is fully paid for by holding corporations and billionaires accountable.


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