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Senate passes Medicare bill that includes Richardton grant program

DICKINSON - Health care providers across the country, and especially hospital officials in Richardton and Dickinson, are singing the praises of the U.S. Senate today after it overturned an earlier vote and passed a Medicare bill Wednesday afternoon that stopped billions of dollars in planned cuts for physician reimbursements.

Richardton and Dickinson hospital officials are additionally thankful for the bill's passage as it includes a program to allow the Richardton Memorial Hospital and Health Center to apply for a $1 million grant program if it chooses to convert to a nursing home. The grant language was conceived by Sen. Kent Conrad, D-N.D., in an ongoing effort to find a solution so Richardton can convert is facility, thereby relinquishing its Medicare Critical Access Hospital status that provides increased reimbursements for services provide.

Financially troubled St. Joseph's Hospital and Health Center in Dickinson can't apply for Critical Access Hospital status under existing federal regulations because it is within 35 miles of the nearest hospital with Critical Access status. St. Joe's continues to take steps to address over $13 million in operational losses that have accumulated since fiscal 2002.

On June 24, the House passed the Medicare bill with the grant language by a 355-59 vote, which was a large enough margin to stop any presidential veto. The Senate two days later originally fell one vote short of the 60 votes needed to pass the bill. Wednesday afternoon, however, the measure passed by a 69-30 vote, as the Sen. Ted Kennedy, D-Mass., who is suffering from a cancerous brain tumor, made a special trip to the Senate chambers to cast a vote in support of the Medicare package.

"I return to the Senate today to keep a promise to our senior citizens, and that's to protect Medicare," the Associated Press reported the senator said in a statement issued by his office as the vote was unfolding.

The AP continued in reporting Kennedy's vote made 60, and when Republicans saw the outcome was sealed, several of them joined Democrats to pad the margin.

Lawmakers are under pressure from doctors and the elderly patients they serve to void a 10.6 percent pay cut for doctors treating Medicare patients, the AP reported. It kicked in July 1 because of a funding formula that establishes lower reimbursement rates when Medicare spending levels exceed established targets. The AP reported some doctors say they'll quit taking new patients if the cuts stand.

Democratic presidential nominee-in-waiting Sen. Barrack Obama issued an e-mail after the Senate vote listing the losses in Medicare reimbursements that were saved as a result of Wednesday's vote. Obama's e-mail stated $30 million in Medicare payments to North Dakota physicians would be lost by December 2009 if the cuts go through.

The e-mail said that would average $15,000 per physician and would impact 7,055 employees and 98,257 Medicare patients.

"Today's vote was a tremendous victory for all of North Dakota," Conrad said in a press release. "Our doctors and nurses provide some of the best health care in the nation - yet they often receive some of the lowest rates of Medicare reimbursement. This bill begins to correct that inequity."

Sen. Byron Dorgan, D-N.D., also praised the Senate vote Wednesday and said in his press release, "Had we not acted again to overturn the Republican majority's filibuster, there would have been substantial cuts to Medicare physician payments, and health care in rural states like North Dakota would have been put at risk."

Conrad and Dorgan were joined by Rep. Earl Pomeroy, D-N.D., in encouraging President Bush to quickly sign the Medicare bill.

"When the Senate Republicans blocked passage of the Medicare bill, I was alarmed about the consequences this would have - a sharp reduction in Medicare reimbursement could impair health care access for seniors and hurt health care delivery in North Dakota," Pomeroy said in a press release after the Senate vote Wednesday. "Now, with the veto-proof passage of this bill in both houses of Congress, I urge the president to quickly sign this bill."

The local task force that has been meeting to resolve the situation before the Richardton and Dickinson hospitals gathered again Wednesday morning in advance of the Senate vote, Richardton Administrator Jim Opdahl said. Opdahl said representatives from the congressional delegation gave an update on the Medicare bill efforts and "they thought they were a vote short of the 60," Opdahl said.

When informed about the vote turnaround Wednesday afternoon, Opdahl said the conversion grant language included in the Medicare bill "will benefit St. Joe's and what needs to happen to benefit the Richardton community as well."

Opdahl said Richardton officials are focusing on the idea of converting to a skilled-nursing facility initially, with a long-term plan that could include other options. He has found the task force effort, which also includes state, local and St. Joe's officials, to be extremely positive.

"All the participants have really generated some positive things and responses," Opdahl said. "I think we're getting really close to laying this thing out so it can happen for both communities."

St. Joe's officials have previously stated that acquiring Critical Access status alone does not allow the Dickinson facility to break even financially, but instead positions it close enough to where it can then take other steps to balance the financial aspects of the overall operation.