Sens. Charles Grassley (R-IA) and Chuck Schumer (D-NY) joined Reps. Tom Reed (R-NY) and Peter Welch (D-VT) late yesterday to introduce the Rural Hospital Access Act (S. 332/H.R. 663), AHA-supported legislation that would make permanent both the Medicare-dependent Hospital program and the enhanced low-volume Medicare adjustment for small rural prospective payment system hospitals. Without congressional action, the current short-term extension of the programs will expire on March 31. In letters of support for the legislation, AHA Executive Vice President Rick Pollack called these “vital programs for America’s rural hospitals and the patients and communities they serve.” Under the MDH program, about 200 hospitals that are more dependent on Medicare revenue because of the high percentage of Medicare beneficiaries in rural areas receive the sum of their PPS payment rate, plus three-quarters of the amount by which their cost per discharge exceeds the PPS rate. The enhanced low-volume adjustment helps level the playing field for hospitals in small and isolated communities, which frequently cannot achieve the economies of scale possible for their larger counterparts.