Public Testimony
At their December meeting, members of the Medicare Payment Advisory Commission discussed the possibility of recommending to the Centers for Medicare & Medicaid Services that it calculate eligible hospitals’ Medicare DSH uncompensated care payments using the S-10 form from hospitals’ Medicare cost report, which ostensibly quantifies the uncompensated care hospitals provide. NAUH has long opposed such an approach and wrote to MedPAC detailing the basis for this opposition.
Institute of Medicine, Committee on Geographic Adjustment Factors in Medicare Payment, Testimony on the Medicare Area Wage Index System. NAUH testifies that the current Medicare area wage index system does a satisfactory job of accounting for geographic variations in labor costs. Instead of creating a new system, NAUH urges the Institute of Medicine to recommend five changes in the current system: 1) create an administrative review process to supplement the current reclassification process; 2) remove the artificial floor of 1.0 for frontier states; 3) remove the artificial labor-related share of 62 percent for hospitals with a wage index lower than 1.0; 4) compute outmigration adjustments annually; and 5) permit post-acute-care providers to be paid the average wage index in effect in their labor market area.
Institute of Medicine, Committee on Geographic Adjustment Factors in Medicare Payment, Testimony on Medicare Geographic Variation Payments. NAUH testifies that there is no basis for supplementing Medicare payments to hospitals in low-cost areas to equalize their Medicare revenue with that of hospitals in higher-cost areas. There are legitimate differences in the cost of delivering care in different parts of the country and supplemental payments made despite these differences would give hospitals money that they do not deserve. Such supplemental payments also would undermine the basic premise of Medicare’s prospective payment system.
In testimony submitted to the House Energy and Commerce Committee on health care reform, NAUH expresses its support for health care reform legislation currently under consideration by the committee, including provisions that would preserve Medicare disproportionate share (Medicare DSH) and Medicaid DSH payments; expand Medicaid eligibility; recognize the special needs of hospitals that care for large numbers of low-income patients; and use Medicare rates as the starting point for payments under a public plan option.