Congressman Cleaver Introduces Bill To Extend Medicare Options In Rural Communities

May 15, 2019
Press Release

(Washington, D.C.) – Last week, Congressman Cleaver introduced H.R. 2666, the Medicare Access to Rural Anesthesiology Act (MARA), which would extend Medicare resources to physician anesthesiologists practicing in rural communities. The bill would amend title XVIII of the Social Security Act to provide payment under Part A of the Medicare Program on a reasonable cost basis for anesthesia services furnished by an anesthesiologist in certain rural hospitals. Currently, payments are only provided for services furnished by anesthesiologist assistants and certified registered nurse anesthetists.

“Some of our most vulnerable citizens come from rural communities, and they are currently limited in the medical options available to them,” Congressman Cleaver said. “With this bill, we are making an effort to ensure folks from small towns have the same access and options available when undergoing surgery as individuals who go to urban hospitals.”

Throughout the nation, rural communities are facing a shortage of physician anesthesiologists partly due to statutes dating back to the 1980s. Typically, Medicare pays for anesthesia providers’ services under the Medicare Part B fee schedule. However, in order to attract anesthesia providers to rural areas, a statutory exception was enacted in the 1980s that allows some rural hospitals to use Part A funds to employ or contract with non-physician anesthesiologist assistants or certified registered nurse anesthetists. While the exception expanded healthcare options in rural communities, it failed to permit hospitals to use the pass through funds to attract physician anesthesiologists, who are able to provide some services that nurse anesthetists and anesthesiologist assistants may not. Congressman Cleaver’s bill will allow some of the smallest hospitals in rural areas to bring in physician anesthesiologists that can provide a wider range of care to these medically underserved communities.

“I want to thank Congressman Jason Smith of Missouri for his bipartisan support on this issue so important to the smaller towns and hospitals across the United States. This bill will go a long way in opening opportunities and access that have been unavailable to rural Americans for far too long,” said Congressman Cleaver.

Emanuel Cleaver, II is the U.S. Representative for Missouri's Fifth Congressional District, which includes Kansas City, Independence, Lee's Summit, Raytown, Grandview, Sugar Creek, Blue Springs, Grain Valley, Oak Grove, North Kansas City, Gladstone, Claycomo, and all of Ray, Lafayette, and Saline Counties. He is a member of the exclusive House Financial Services Committee; Chairman of the House Subcommittee on National Security, International Development, and Monetary Policy; member of the Select Committee on the Modernization of Congress; member of the Committee on Homeland Security; and a Senior Whip of the Democratic Caucus. For more information, please contact Matthew Helfant at 202-225-4535 or A high-resolution photo of Congressman Cleaver is available here.