Congressman Bill Thomas (R-CA), Chairman, Subcommittee on Health of the Committee on Ways and Means, today announced that the Subcommittee will hold a hearing on teaching hospitals and Medicare disproportionate share hospital payments. The hearing will take place on Tuesday, March 11, 1997, in 1310 Longworth House Office Building, beginning at 1:00 p.m.
In view of the limited time available to hear witnesses, oral testimony at this hearing will be heard from invited witnesses only. However, any individual or organization not scheduled for an oral appearance may submit a written statement for consideration by the Committee and for inclusion in the printed record of the hearing.
BACKGROUND
Teaching hospitals provide critical services to Medicare beneficiaries and others as well as training health care providers and producing state of the art medical research. Costs of operating teaching hospitals tend to be higher than those in other hospitals, in large part due to their multiple missions related of patient care, education, and research. Medicare recognizes these higher costs through graduate medical education (GME) payments: direct GME and an indirect medical education (IME) adjustment. For fiscal year 1996, Medicare payments to teaching hospitals for direct GME were $2.2 billion and IME payments were $4.3 billion.
The Balanced Budget Act of 1995 would have reformed Medicare payment for teaching hospitals and GME through the establishment of a trust fund to support these activities. Despite President Clinton's veto of the Balanced Budget Act of 1995, the Subcommittee remains committed to reforming Federal support for teaching hospitals and will examine the President's fiscal year 1998 budget proposals regarding GME in this context.
In addition to GME payments, Medicare makes payments to hospitals that tend to serve a larger proportion of indigent Medicare beneficiaries. Referred to as the Medicare disproportionate share hospital (DSH) adjustment, payment is made through a percentage add-on to the hospital rate using Medicaid and Supplemental Security Income as a proxy. Because of changes in both Medicaid and welfare, the use of these factors to compute the disproportionate share payment requires reexamination. In recent years, Medicare DSH payments have increased nearly 400 percent, from $1.1 billion in fiscal year 1989 to $4.3 billion in 1996.
In announcing the hearing, Chairman Thomas stated: "Across the country, teaching hospitals have assumed an important role in the communities they serve. These institutions are currently being challenged by a changing health care system. They are rightly concerned over Medicare spending proposals. It is time to take a close look at the Federal contribution to these hospitals , and decide how that contribution can be better focused to maintain the best of what these institutions have to offer."
FOCUS OF THE HEARING
This hearing will focus on special payments to teaching hospitals for GME and Medicare DSH payments.
DETAILS FOR SUBMISSION OF WRITTEN COMMENTS
Any person or organization wishing to submit a written statement for the printed record of the hearing should submit at least six (6) copies of their statement and a 3.5-inch diskette in WordPerfect or ASCII format, with their address and date of hearing noted, by the close of business, Tuesday, March 25, 1997, to A.L. Singleton, Chief of Staff, Committee on Ways and Means, U.S. House of Representatives, 1102 Longworth House Office Building, Washington, D.C. 20515. If those filing written statements wish to have their statements distributed to the press and interested public at the hearing, they may deliver 200 additional copies for this purpose to the Subcommittee on Health office, room 1136 Longworth House Office Building, at least one hour before the hearing begins.
FORMATTING REQUIREMENTS
Each statement presented for printing to the Committee by a witness, any written statement or exhibit submitted for the printed record or any written comments in response to a request for written comments must conform to the guidelines listed below. Any statement or exhibit not in compliance with these guidelines will not be printed, but will be maintained in the Committee files for review and use by the Committee.
1. All statements and any accompanying exhibits for printing must be typed in single space on legal-size paper and may not exceed a total of 10 pages including attachments. At the same time written statements are submitted to the Committee, witnesses are now requested to submit their statements on a 3.5-inch diskette in WordPerfect or ASCII format.
2. Copies of whole documents submitted as exhibit material will not be accepted for printing. Instead, exhibit material should be referenced and quoted or paraphrased. All exhibit material not meeting these specifications will be maintained in the Committee files for review and use by the Committee.
3. A witness appearing at a public hearing, or submitting a statement for the record of a public hearing, or submitting written comments in response to a published request for comments by the Committee, must include on his statement or submission a list of all clients, persons, or organizations on whose behalf the witness appears.
4. A supplemental sheet must accompany each statement listing the name, full address, a telephone number where the witness or the designated representative may be reached and a topical outline or summary of the comments and recommendations in the full statement. This supplemental sheet will not be included in the printed record.
The above restrictions and limitations apply only to material being submitted for printing. Statements and exhibits or supplementary material submitted solely for distribution to the Members, the press and the public during the course of a public hearing may be submitted in other forms.
The
Committee seeks to make its facilities accessible to persons with
disabilities. If you are in need of special accommodations, please
call 202-225-1721 or 202-225-1904 TTD/TTY in advance of the event
(four business days notice is requested). Questions with regard to
special accommodation needs in general (including availability of
Committee materials in alternative formats) may be directed to the
Committee as noted above.