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Patient Protection & Affordable Care Act, US Senate 2009: Frontier Provisions. Beth Landon beth.landon@uaa.alaska.edu Immediate Past-President, NRHA Director, Alaska Center for Rural Health – AHEC, UAA. Final Thought – 4 Pillars for RED. Data Collection p. 1248. Education

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Patient Protection & Affordable Care Act, US Senate 2009: Frontier Provisions

Beth Landon

beth.landon@uaa.alaska.edu

Immediate Past-President, NRHA

Director, Alaska Center for Rural Health – AHEC, UAA

final thought 4 pillars for red
Final Thought – 4 Pillars for RED

Data Collection p. 1248

  • Education
  • Public Infrastructure
  • Social Infrastructure
  • Entrepreneurialism

Title XXXI – Data Collection, Analysis and Quality

SEC. 3101.

“(f) Data on Rural Underserved Populations.

- The Secretary shall ensure that any data collected in accordance with this section regarding racial and ethnic minority groups are also collected regarding underserved rural and frontier populations.”

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Frontier HPSA, p.1274

  • Title V – Health Care Workforce
  • Subtitle A – Purpose and Definitions
  • (18) Frontier Health Professional Shortage Area.
  • The term ‘frontier health professional shortage area’ means an area
  • “(A) with a population density less than six persons per square mile within the service area; and
  • “(B) with respect to which the distance or time for the population to access care is excessive.
  • Inserted by WY Senator Enzi and AK Senator Murkowski during the HELP Committee hearings
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National Health Care Workforce Commission

SEC. 5101 National Health Care Workforce Commission.

(a) Purpose. – It is the purpose of this section to establish a National Health Care Workforce Commission. . ..

P. 1279

(ii) who will provide a combination of professional perspectives, broad geographic representation, and a balance between urban, suburban, rural and frontier representatives.

- Inserted by NM Senator Bingaman, from his April 2009 workforce bill

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Independent Medicare Advisory Board

Under the bill, the proposed Medicare board must “give priority to recommendations that extend Medicare solvency” and include recommendations that: “protect and improve Medicare beneficiaries’ access to necessary and evidence-based items and services, including in rural and frontier areas.”

- Introduced by WV Senator Rockefeller

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1.0 Floor on the Wage Index for Frontier States

-Pages 208-212 – Wage Index Floor for Hospitals and Physicians in Select “Frontier” States (section 10324)- Would establish and apply a hospital wage index floor of 1.0 for inpatient hospital services and outpatient services in "frontier" states (defined as any state where more than half of its counties have a population density of less than 6 persons per square mile. A floor of 1.0 would also apply to the practice expense for physician services provided on or after January 1, 2011 in these frontier states.

- This addition was introduced by NV Senator Reid as part of the Manager’s Amendments. It expands a provision for Alaska to also include Montana, Nevada, South Dakota, North Dakota and Wyoming.

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Frontier Clinic Grant Program

  • Proposed Frontier Clinic Grant Program
  • Block funding, to support (24/7) staff, equipment, and facility upgrades
  • Would provide support to frontier clinics in Alaska, Montana, New Mexico, Montana, Wyoming, California, Oregon and other states
  • Would save Medicare dollars by reducing hospital admissions and medevacs
  • Eligibility
  • 1) The clinic must be located in a community where the closest short-term acute care hospital or critical access hospital is at least 60 miles/60 minutes from the community or is inaccessible by public road; and 2) designed to address the needs of –
  • seriously or critically ill or injured patients for stabilization prior to transport to definitive care; and
  • patients who need monitoring and observation for a limited period of time.
  • - This amendment was not successfully included in the bill