Rural Pass Through Legislation

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However, many states face ongoing challenges in assuring access to medical care services for their citizens living in rural areas. Insufficient Medicare payments and low patient volume have made it particularly difficult for many rural facilities to attract and retain qualified health care providers, including physician anesthesiologists. </p> </div> </div> </div> </div>  </div> </div> </div>  <div class="container"> <div class="row"> <div class="col-md-6"> <div class="rt-container external-links"> <h2 style="margin:28px 0px 18px 0px;">What You Should Know</h2> <ul> <li style="margin-bottom:24px;">In response to these challenges, Congress has enacted a variety of incentive programs to encourage providers to practice in rural areas. </li> <li style="margin-bottom:24px;">One such program is the anesthesia rural “pass-through” program – a program created as an incentive for anesthesia providers to practice in small rural hospitals. </li> <li style="margin-bottom:24px;">Under the “pass-through” program, eligible hospitals may use reasonable-costs based Part A payments in lieu of the conventional Part B payments as a rural practice inducement for non-physician anesthesia providers such as anesthesiologist assistants (a type of physician assistant) and nurse anesthetists to practice in small, low volume rural hospitals. Under the Centers for Medicare and Medicaid Services (CMS) current interpretation of the current “pass-through” program, eligible small rural hospitals are not permitted to use the “pass-through” funds to hire physician anesthesiologists. Changes are necessary to expand rural access to the services of physician anesthesiologists. </li> </ul> </div> </div> <div class="col-md-6"> <div class="rt-container external-links"> <h2 style="margin:28px 0px 18px 0px;">What ASA is Doing For You</h2> <ul> <li style="margin-bottom:24px;">The American Society of Anesthesiologists, through formal comment, requested that CMS permit rural hospitals to use the rural pass-through arrangement for anesthesiologists, as well as the other providers. CMS responded that it cannot permit hospitals to use the pass-through arrangement for anesthesiologists without a change in the current law. </li> <li style="margin-bottom:24px;">Last Congress, Rep. John Moolenaar (R-MI-2) and Rep. Jared Huffman (D-CA-2) introduced the bipartisan Medicare Access to Rural Anesthesiology Act which would reform the program and allow rural hospitals to use already available “pass-through” funds to employ or contract with all types of anesthesia providers – physician anesthesiologists, as well as anesthesiologist assistants and nurse anesthetists. ASA strongly supported this legislation.</li> </ul> </div> </div> </div> </div>  <div class="container"> <div class="row"> <div class="col-md-12"> <div class="rt-container external-links"> <h2 style="margin:28px 0px 18px 0px;">What You Can Do Now</h2> <h3 style="margin:8px 0px 18px 0px;">Resources and actions you can take today </h3> <p style="line-height:14px;margin:0px;padding:0px;"> </p> </div> </div> </div> </div>  <div class="container"> <div class="row"> <div class="col-md-12">  <div class="container"> <div class="row"> <div class="col-md-3"> <div class="h3-tile" style=""> <a href="/-/media/sites/asahq/files/public/advocacy/federal-activities/legislative-activity/rpt-one-pager-2025doc.pdf" > <div class="img-container"> <div class="img-cap"> <img src="/-/media/images/news/general-anesthesia_960x539.png?mh=539&la=en&h=539&w=960&mw=960&hash=DE845A74B6EFEF5BEF649329BF46A528" class="fill" alt="Patient with breathing mask on operating table undergoing general anesthesia for surgery " /> </div> </div> <h3 class="h3-tile-header">Anesthesia Rural Pass-Through One-Pager</h3> <p class="h3-tile-description">Explanation of the program that encourages anesthesia providers to practice in small rural hospitals.</p> </a> <a href="/-/media/sites/asahq/files/public/advocacy/federal-activities/legislative-activity/rural-pass-through-1-pager.pdf" class="btn-primary h3-tile-button" >See the PDF brief ></a> </div> </div> <div class="col-md-3"> <div class="h3-tile" style=""> <a href="/-/media/sites/asahq/files/public/advocacy/federal-activities/legislative-activity/rural-pass-through-faq-draft-final.pdf" > <div class="img-container"> <div class="img-cap"> <img src="/-/media/sites/psh/images/960x539/psh-resources/psh-3-faqs.png?mh=539&la=en&h=539&w=960&mw=960&hash=BADD6E9D4FC03D5C02558736C55A463F" class="fill" alt="Answers to your PSH questions" /> </div> </div> <h3 class="h3-tile-header">Rural Pass-Through FAQ</h3> <p class="h3-tile-description">Learn more about Rural Pass-Through and why it's important to include physician anesthesiologists.</p> </a> <a href="/-/media/sites/asahq/files/public/advocacy/federal-activities/legislative-activity/rural-pass-through-faq-draft-final.pdf" class="btn-primary h3-tile-button" >Review the PDF ></a> </div> </div> <div class="col-md-3"> <div class="h3-tile" style=""> <a href="/-/media/sites/asahq/files/public/advocacy/federal-activities/legislative-activity/20230410-rural-pass-through-eligible-hospitals-by-district.pdf" > <div class="img-container"> <div class="img-cap"> <img src="/-/media/images/news/medicare-960x539.png?mh=539&la=en&h=539&w=960&mw=960&hash=CFEEAE6599D46FB10D94A81922DEB93B" class="fill" alt="Medicare" /> </div> </div> <h3 class="h3-tile-header">Eligible Hospitals List</h3> <p class="h3-tile-description">Download to review the list of Rural Pass-Through hospitals (updated 2023).</p> </a> <a href="/-/media/sites/asahq/files/public/advocacy/federal-activities/legislative-activity/20230410-rural-pass-through-eligible-hospitals-by-district.pdf" class="btn-primary h3-tile-button" >See List PDF ></a> </div> </div> <div class="col-md-3"> </div> </div> </div>  </div> </div> </div>  <div class="container"> <div class="row"> <div class="col-md-12"> <div class="rt-container external-links"> <div style="line-height:60px;"> </div> </div> </div> </div> </div>  <div class="container"> <div class="row"> <div class="col-md-3"> <div class="h3-tile" style=""> <a href="/about-asa/newsroom/news-releases/2023/08/asa-applauds-introduction-of-medicare-access-to-rural-anesthesiology-act" > <div class="img-container"> <div class="img-cap"> <img src="/-/media/images/news/physician-talking-to-elderly-patient-960x539.png?mh=539&la=en&h=539&w=960&mw=960&hash=67C9F7CC2E27FB683640DF8D6C5B1FCC" class="fill" alt="Physician talking to elderly patient" /> </div> </div> <h3 class="h3-tile-header">Medicare Access to Rural Anesthesiology Act Press Release</h3> <p class="h3-tile-description">ASA-endorsed legislation would expand rural patients’ access to physician anesthesia care.</p> </a> <a href="/about-asa/newsroom/news-releases/2023/08/asa-applauds-introduction-of-medicare-access-to-rural-anesthesiology-act" class="btn-primary h3-tile-button" >Read more ></a> </div> </div> <div class="col-md-3"> <div class="h3-tile" style=""> <a href="https://moolenaar.house.gov/media-center/press-releases/moolenaar-huffman-introduce-legislation-support-seniors-rural" > <div class="img-container"> <div class="img-cap"> <img src="/-/media/sites/bhealth/960x539/coga-pbhi-survey-2020-960x539px.jpg?mh=539&la=en&h=539&w=960&mw=960&hash=3342CE1FF0CB8B33E7D5C5B6F700ADBB" class="fill" alt="The ASA Committee on Geriatric Anesthesia and the ASA Perioperative Brain Health Initiative undertook a survey of ASA members to characterize current practices related to perioperative care of older adults." /> </div> </div> <h3 class="h3-tile-header">Legislation to Support Seniors</h3> <p class="h3-tile-description">Legislation introduced last Congress would have allowed rural hospitals to use federal funding through Medicare to hire physician anesthesiologists. </p> </a> <a href="https://moolenaar.house.gov/media-center/press-releases/moolenaar-huffman-introduce-legislation-support-seniors-rural" class="btn-primary h3-tile-button" >See the details ></a> </div> </div> <div class="col-md-3"> </div> <div class="col-md-3"> </div> </div> </div>  <div class="container"> <div class="row"> <div class="col-md-12"> </div> </div> </div>  <div class="container"> <div class="row"> <div class="col-md-12"> <div class="rt-container external-links"> <div style="line-height:36px;"> </div> <p style="margin-top:40px;">This page is curated by Amanda Cate, Associate Director of Governmental and Political Outreach, and was last updated September 2023. </p> </div> </div> </div> </div>  <div class="container"> <div class="row"> 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