As one of the most rural states in the nation,
North Dakota faces special challenges in providing quality health care
to all its citizens. More than 90 percent of North Dakota's rural
counties lack full access to affordable, quality health care. Senator
Conrad is focused on numerous health care issues that are important
to North Dakotans, including:
Access to Rural Hospitals
Emergency Services
Health Care Services for North Dakota
Health Care Cost
Access to Rural Providers
Senator Conrad recognizes that one of the keys to maintaining
North Dakota's health care system is supporting the state's
rural hospitals, many of which depend on Medicare reimbursement to remain
viable. Senator Conrad has visited every hospital in North Dakota and
has seen the tremendously positive impact these institutions have on
their communities. As a member of the Senate Finance Committee, Senator
Conrad has been a leader in fighting to address Medicare payment flaws
that have harmed rural health care providers across North Dakota. In
recent years, Senator Conrad has been successful in making changes to
the Medicare payment rules, which will bring increased payments to rural
hospitals, as well as physicians, home health care agencies, nursing
homes, rural health clinics and renal dialysis facilities across the
state.
In the 108th Congress, Senator Conrad was successful in securing
nearly $177 million in improved payments to North Dakota health
care providers as part of the Medicare Modernization Act of
2003. These funds have helped to address the payment inequities
between North Dakota hospitals and large urban facilities in
other parts of the country and have kept many of our rural hospitals
open.
More recently, Senator Conrad introduced new rural Medicare
legislation designed to further close the gap in reimbursement
and extend several of the provisions included in the 2003 Medicare
bill. The bipartisan Craig Thomas Rural Hospital and Provider
Equity Act, or R-HoPE, would significantly overhaul Medicare's
rural health policy by creating a fund for small town hospitals
to repair crumbling buildings, providing for home health care
and boosting payments to rural ambulance squads. In addition,
the bill extends a key provision that has helped several North
Dakota hospitals receive higher Medicare payments to better
account for the labor costs of serving in a rural state. Senator
Conrad's bill has already won support from health care organizations
including the National Rural Health Association, the American
Hospital Association and the American Ambulance Association.
He will continue to work to have this legislation considered
by the full Senate.
Senator Conrad has also fought to ensure critical rural health programs,
such as the Rural Hospital Flexibility program and the Rural Health
Outreach grant program, receive adequate funding. These vital programs
are used to meet a variety of health care needs in rural America, including
developing local public health programs and helping support the smallest,
critical access hospitals in North Dakota.
Specifically, Senator Conrad wrote a budget for fiscal year
(FY) 2008 that rejected President Bush's cuts to vital rural
health programs and instead provided $163 million, a $146 million
increase above the President's request. Without these efforts,
several rural health care programs would have been eliminated.
In addition, Senator Conrad has consistently been the lead supporter
of the annual appropriations request for vital rural health
programs.
Emergency Services
Senator Conrad recognizes that access to emergency medical
services (EMS) is vital in every community across America, particularly
in rural communities where individuals may have to travel long distances
to reach the closest hospital.
In recent years, there has been increasing concern about access to
emergency care as the number of individuals able to provide these services
continues to decline. In many communities, the majority of emergency
medical personnel are unpaid volunteers, particularly in rural areas.
As rural economies continue to struggle, and individuals have less and
less time to volunteer, it has become increasingly difficult for rural
EMS squads to recruit and retain personnel.
Senator Conrad has fought to ensure access to emergency services
in rural areas by increasing Medicare reimbursement. For example,
during debate on the Medicare Modernization Act, Conrad supported
efforts to provide a 2 percent add-on payment for rural ambulance
squads and a 25 percent bonus payment for trips over 50 miles.
Although the Medicare bill took steps to help ambulance services,
many rural squads still operate on negative margins. Senator
Conrad has recognized this, and recently introduced a bipartisan
bill to further help rural ambulance services. The Medicare
Ambulance Payment Extension Act would improve Medicare reimbursement
for rural squads and improve the quality of care provided in
rural areas. The bill has been endorsed by several organizations,
including the American Ambulance Association, the National Rural
Health Association and the National Association of Emergency
Medical Technicians.
In addition, Conrad has fought against Administrative rules that could
have resulted in several North Dakota ambulance services closing. Specifically,
in 2005, Conrad argued against overly burdensome training requirements
that would have harmed the ability of our volunteer EMS services to
recruit and retain personnel. Moreover, in 2006 Senator Conrad was successful
in blocking the elimination of the “Super Rural Bonus” for
11 ambulance services across the state that would have represented over
a 23 percent cut in funding, forcing these services to close.
Health Care Services for North Dakota
Senator Conrad is always working to find new, innovative ways
to bring health care services to North Dakota. One such effort is the
"J-1 visa waiver" program, which he successfully amended to
make it easier for foreign medical graduates to work in rural communities.
In 2002, Senator Conrad worked to expand this program to allow North
Dakota communities to employ a greater number of foreign doctors in
areas that do not have enough doctors, nurses and other health care
providers. This expansion will help ensure patients in smaller and more
remote communities continue to have access to vital medical services.
Working in a bipartisan manner, Senator Conrad was successful in pushing
for this measure to be passed in both the Senate and House of Representatives.
In 2004, Senator Conrad was successful in reauthorizing his Conrad State
30 Program. As part of this effort, Senator Conrad worked to expand
the program so that states will have flexibility to determine which
of their communities need physicians and specialists. This will allow
hospitals in urban areas, such as Fargo and Bismarck, to recruit specialists
who will provide services to patients from surrounding areas. Most recently,
Conrad was successful in securing a two-year extension of the program
through June 2008. Conrad will continue to fight in 2007 to have this
vital program made permanent.
Telemedicine, also known as Telehealth, is another innovation in health
care that North Dakota is beginning to utilize with help from Senator
Conrad. Telehealth allows patients in remote rural areas to consult
with specialists via video. This option gives North Dakotans access
to cutting edge medical care without having to drive long distances
to reach a clinic or specialist. In many instances Telehealth can help
prevent more serious or expensive procedures by providing an early diagnosis.
In 1993, Senator Conrad formed the Steering Committee on Telehealth
to raise awareness about this innovative treatment option. Legislation
introduced by Senator Conrad helped address several of the barriers
to Telehealth and a portion of his bill, the Comprehensive Telehealth
Act of 1997, was enacted into law as part of the Balanced Budget
Act of 1997. As a result, Medicare now reimburses doctors for
providing Telehealth services to seniors and the disabled in
underserved rural areas. In past Congresses, the Senator has
convened a series of educational meetings to explore new developments
related to expanding the use of Telehealth. Experts in the field,
government agency representatives, and Members of Congress attended
these meetings. Senator Conrad has continued to hold this educational
series in the 110th Congress and uses the information gathered
to inform the Senate's legislative agenda on Telehealth.
Senator Conrad is also interested in the use of telehealth in public
health emergencies. Most recently, he was successful in getting his
proposal, the National Emergency Telemedical Communications Act (NETCA),
included in broader bioterrorism legislation. NETCA would establish
a regional grant program to create telehealth networks that can help
respond to bioterrorist attacks or other public health emergencies.
Conrad will work in 2007 to secure funding for this newly authorized
program.
In addition, Senator Conrad is interested in health information technology
(IT) and making our health care system more efficient by adopting
an electronic medical record. He believes this technology has
the potential to improve the quality of care and reduce health
care costs. Given his focus on this issue, Senator Conrad hosted
North Dakota's first Health
IT Summit in April 2006. In 2007, he has continued to work
with the North Dakota Health IT Steering Committee, which was
founded after his Health IT Summit, to expand the use of electronic
medical records in North Dakota.
Health Care Costs
The high cost of health care in North Dakota is also a top concern for
Senator Conrad. He has fought for 100 percent tax deductibility of health
insurance premiums for the self-employed. He also supported the Medicare
Modernization Act, which is helping many seniors better afford needed
medications. Senator Conrad has also supported measures to bring U.S.
drug pricing in line with lower prices offered in other countries and
to improve North Dakotans' access to lower-priced generic drugs.
One of Senator Conrad's highest priorities in the U.S. Senate
has been to make prescription drugs more affordable for seniors. The
new Medicare prescription drug benefit has
the potential to help thousands of North Dakota's seniors get
the drugs they need; however, Senator Conrad has expressed serious concerns
– in public forums and private meetings – about the Medicare
program's implementation of this new benefit.
Senator Conrad has also supported other efforts to reduce health care
costs and protect access to vital health care services. As a
member of the bipartisan Mainstream Coalition on Health Care
Reform, he worked on a compromise that would have helped to
hold down the rapidly growing costs of health care. Senator
Conrad is also a strong supporter of the Medicaid program, which
provides a health care safety net for low income North Dakotans.
In addition, he is a strong supporter of the S-CHIP program
which also helps ensure that children have access to quality
health care. Most recently, Conrad's FY 2008 budget document
included provisions that could dramatically increase the number
of children with health insurance. Senator Conrad will continue
to work in the 110th Congress to ensure all North Dakotans have
access to affordable and quality health care services.
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![Senator Conrad explains the Medicare Bill to an audience at Cooperstown Medical Center.](https://webarchive.library.unt.edu/eot2008/20081126222032im_/https://conrad.senate.gov/images/issues_healthcare.jpg)
Senator Conrad Proposes Medicare Mend Bill
Conrad, Whitehouse Call for GAO Health Reform Study
(11/25/08)
Senator Works to Spread Awareness of Diabetes
(11/17/08)
Senate Extends Popular Conrad State 30 Program
(09/26/08)
CONRAD SECURES MORE THAN $940,000 TO CONVERT RICHARDTON HOSPITAL TO LONG-TERM CARE FACILITY
(09/22/08)
Conrad Helps Break Ground on Rolette Care Center
(08/05/08)
Senator Conrad's 2008 Health Care Report (.pdf)
Conrad
Secures Big Wins for ND's Hospitals
(12-11-06) (mp3)
Senator
Grills Medicare Chief on New Rx Drug Plan
(02-08-06) (.mp3)
Conrad's
Telehealth Initiative Connects Communities to Cutting-Edge Medical Care
(06-23-04) (.mp3)
Facts
About the Medicare Mend Bill
(04-22-04)
Floor
Statement on the Medicare Improvement Act
(04-22-04)
Senator
Conrad explains his Medicare Mend bill.
(04-22-04) (0.9 mb)
Floor
Statement on the Medicare Vote
(11-25-2003)
Facts
about the Medicare Bill for North Dakota
(11-25-2003)
North Dakota
Facts on H-CARE (Health Care Access & Rural Equity Bill of 2003)
(04-08-2003)
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