WASHINGTON – Tiny hospitals in rural Oregon that receive federal assistance would be allowed to nearly double in size without jeopardizing their aid from Washington under a bill passed by the Senate last week.

Under the proposal, rural Oregon’s health care system could receive $122 million more in federal assistance over 10 years.

The extra $25 billion for rural hospitals nationwide over 10 years, cosponsored by Sen. Gordon Smith, R-Ore., was included in a bill that would add a prescription drug benefit to Medicare. The Senate approved the measure 76-12 on Friday.

Currently, hospitals that have 15 or fewer acute care beds, like Pioneer Memorial Hospital in Heppner, get up to $350,000 a year to pay for ambulance maintenance and medical costs because they qualify as ”critical access hospitals.”

The bill would expand that to include hospitals with up to 25 acute care beds to be called critical access hospitals, giving more small rural medical centers access to the $350,000 a year in aid.

Pioneer Memorial Hospital in Prineville was designated a critical access hospital earlier this year and could expand and still qualify for the additional beds under the legislation. But officials there said they were not certain that the hospital needed to expand.

Mountain View Hospital in Madras doesn’t have critical access status.

But for some rural hospitals the extra revenue can be important, said Karen Whitaker, director of the Oregon Office of Rural Health.

”It can be the difference between red and black on their bottom line,” Whitaker said.

The Senate bill also would increase by about 5 percent the amount given to the small hospitals to operate their ambulances.

In Heppner, the extra money could go toward new equipment on the eight ambulances that serve Morrow County, said Victor Vander Does, the chief administrator.

For St. Elizabeth Hospital in Baker City, which hopes to secure designation as a critical access hospital today, the Senate plan ”just gives us a little more flexibility,” said administrator George Winn.

A committee of senators and House members now will meet to try to resolve differences between the Senate bill and a similar bill that cleared the House of Representatives by just one vote Friday. The House bill would allocate much less money for rural health care – $8.5 million over 10 years.

Another part of the House bill, though, would be a big help for Medicare patients. It would scrap an automatic 4.2 percent drop in Medicare reimbursements scheduled to take effect next January.

Robert Dernedde, executive director of the Oregon Medical Association, said a recent OMA survey found that half of Oregon’s doctors had purged Medicare patients from their practices or were not accepting any new Medicare patients because the federal government was reimbursing them less and less for treating Medicare patients. Under the House plan, Dernedde said, doctors would enjoy a slight increase in Medicare payments for a change.

James Fisher will be covering Central Oregon issues in Washington, D.C., for the summer for The Bulletin. He is working through an arrangement with the graduate journalism program at Northwestern University. Fisher can be reached at 202-661-0151 or at fisherjam@mac.com.