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Schumer Says Critical Access Hospital (CAH) Status Provides Rural Hospitals Like Alice Hyde With Enhanced Reimbursement Rates To Keep Healthcare Services In Underserved Communities Like Those In Malone

Schumer Has Been A Champion Of THE CAH Program For Years And Successfully Saved Several Upstate New York Hospitals At Risk Of Losing Their CAH Status Last Year; As A Result, Schumer Says CAH Status Is Now Heading To Another North Country Hospital, Helping Alice Hyde To Continue Lifesaving Care And Essential Medical Procedures

Schumer: CAH Designation Will Be a Game Changer For Alice Hyde And The Franklin County Communities It Serves!

Following his advocacy, U.S. Senate Majority Leader Charles E. Schumer today announced that Alice Hyde Medical Center has been designated as a Critical Access Hospital (CAH) by the Centers for Medicare & Medicaid Services (CMS). Schumer said that Alice Hyde’s new status will reduce the community hospital’s financial vulnerability amid financial and operational challenges for rural health care organizations in New York and across the country. Schumer has been a champion of the CAH program for years and successfully saved several Upstate New York hospitals at risk of losing their CAH status last year.

"I am thrilled to announce that Alice Hyde Medical Center has received Critical Access Hospital (CAH) designation, the result of relentless advocacy to secure essential healthcare services for communities across Franklin County. This designation is a game-changer for Alice Hyde, providing enhanced reimbursement rates that will fortify its financial resilience amid the current challenges facing rural health care organizations,” said Senator Schumer. “That’s why I fought so hard last year to reverse CMS's ill-fated rules change and fought tooth and nail for the CAH program – safeguarding the lifeline of critical medical procedures and lifesaving care for Malone residents. This victory for Alice Hyde underscores the importance of advocating for our rural hospitals in Franklin County and across New York State, ensuring they receive the support they need to thrive for generations to come.”

“Critical Access Hospital status is essential to Alice Hyde’s future and directly supports our commitment to caring for communities across Franklin County. We are fortunate to have strong legislative partners like Senator Schumer, and grateful for his commitment to working with rural hospitals like ours, to ensure our communities continue to have access to high-quality, compassionate care as close to home as possible,” said Alice Hyde Medical Center President Michelle LeBeau.

Schumer explained that the CAH program specifically allows smaller rural providers, like those in the North Country, with the designation to receive greater federal reimbursements for care to keep these otherwise financially vulnerable rural hospitals in the communities that need them most. Schumer’s office advocated directly to CMS on behalf of Alice Hyde to receive this vital designation.

Prior the receiving this designation, Alice Hyde was considered a Sole Community Hospital by CMS, meaning it received lower reimbursement for services for patients on federally-funded health insurance plans such as Medicare, which make up a significant portion of the population served by the hospital. CAH hospitals are reimbursed 101 percent of “reasonable costs” for services, while the federal reimbursement rate for non-CAH hospitals is much lower. Alice Hyde estimates that it will receive between $3 million and $4.5 million more per year in service reimbursements with its new status as a CAH.

In 2015, the CMS issued a new policy change without going through the proper notice and rulemaking required by law that would enact more restrictive eligibility definitions for the CAH program, costing rural hospitals millions. Schumer immediately began leading the fight to maintain CAH status for Upstate’s rural hospitals, sending multiple letters highlighting the issue and the impact it would have on rural residents, and personally called HHS Secretary Xavier Becerra to fix this bureaucratic mistake that could cost thousands of rural family’s critical healthcare services. As a result of Schumer’s advocacy, CMS announced last year that it would propose to reverse this disastrous policy and clarify the language that would have caused New York’s CAH’s to lose their status, which was finalized in November 2022. The decision to undo the previous ruling that changed the guidelines was finalized and went into effect on January 1, 2023, allowing current hospitals to maintain their CAH status, and other hospitals, which were previously denied, to reapply for this designation to potentially receive millions in critical reimbursements.

The CAH designation was created by the Balanced Budget Act of 1997 to give small rural healthcare providers greater financial reimbursement for servicing Medicare and Medicaid patients, as well as provide other resources, in order to keep vulnerable rural hospitals financially stable. One factor for CAH eligibility requires that a hospital be a certain distance from another hospital by either a primary or secondary road and provide around-the-clock emergency services. Previously, CMS regulations stated that a CAH hospital must be at least 35 miles from the nearest hospital by “primary road”, defined as any road in an interstate system or a US-numbered highway, or at least 15 miles in areas with mountainous terrain or only “secondary roads”, defined to include single lane state routes.