U.S. Department of Health and Human Services

EXECUTIVE SECRETARY:
Wayne Myers M.D.
Rockville, MD

Dear Secretary Shalala,

The National Advisory Committee on Rural Health recently completed its June meeting in Checoteh, Oklahoma June 3-7, 2000 and I would like to share with you some highlights of our discussion. As you know, the Committee has chosen to spend the next year focusing on Medicare reform and its potential impact on rural health care. While we understand that it is unlikely that any reform legislation will pass this year, we do believe it is important for rural voices to be heard as the Congress and the Administration continue to debate this issue. I am sending to you one recommendation on prescription drugs that grew out of our discussion as well as a series of general concerns on key Medicare reform issues.

We offer the recommendation on prescription drugs should the Congress and the Administration reach agreement on adding a prescription drug benefit to Medicare before the legislative session ends. The Committee believes it is important that any legislation passed include protections that allow rural community pharmacists to compete to serve Medicare beneficiaries under any new benefit structure.

We offer the additional attachment, "Key Rural Issues for Medicare Reform," as a response to both the President's Medicare reform plan and the leading Senate proposal put forth by Senators Breaux and Frist. We offer these general concerns to ensure that rural issues continue to be part of the larger debate on Medicare reform.

During its meeting, the Committee met and discussed a wide range of issues with health officials of both the Choctaw and Creek Indian tribes. The Committee understands that the Administration is discussing a demonstration project between the Indian Health Service and the Health Care Financing Administration to make it easier for the Tribes to bill directly for Medicare services for Native American beneficiaries. We are encouraged by this dialogue and hope that the demonstration moves ahead as quickly as possible.

Thank you again for your support of rural health. We appreciate your active support of important rural health issues during your tenure as Secretary and we look forward to working with you on the issues delineated above. I look forward to hearing from you soon.

Sincerely,

Nancy Kassebaum Baker