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 rehabilitation and long-term care hospitals. The hearing will take place on Thursday, April 10, 1997, in room 1310 Longworth House Office Building, beginning at 1:00 p.m.
In view of the limited time available to hear witnesses, oral testimony 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:
Medicare payments to rehabilitation facilities and long-term care hospitals have increased rapidly in recent years. The Prospective Payment Assessment Commission recently examined Medicare spending for these providers. Between 1990 and 1994, rehabilitation facility payments increased from $1.9 billion to $3.9 billion--an average annual increase of 20 percent. Long-term care hospital payments increased from $200 million to $800 million--an average annual increase of 41 percent.
Rehabilitation facilities and long-term care hospitals are paid under a system established in the Tax Equity and Fiscal Responsibility Act of 1982 (TEFRA). Under TEFRA, operating payments are based on an individual facility's costs or a facility-specific limit. The discharge-level limits are calculated for each individual hospital using cost report data from the second year that the facility is in operation, updated to the current year. Therefore, for some hospitals, their target payments are based on cost report data that is more than a decade old. Capital payments are based on costs.
TEFRA was intended to be an interim system until a prospective payments system (PPS) could be established. Fifteen years later, rehabilitation and long-term care hospitals remain under this "temporary" system. In the Omnibus Budget Reconciliation Act of 1990, the Secretary of Health and Human Services was instructed to reform the TEFRA system or replace it with a PPS. There has been little progress in this area.
The President's fiscal year 1998 budget proposal contains provisions to recalculate all TEFRA hospital targets using more recent cost report data. A target ceiling and floor would be imposed to reduce the variation across facilities. Capital payments would also be reduced to 85 percent of costs, for fiscal years 1998 through 2002. In addition, the Administration would impose a moratorium on long-term care hospitals, effective upon enactment.
In announcing the hearing, Chairman Thomas stated: "Medicare payments for rehabilitation facilities and long-term care hospitals are spiraling upward. Notwithstanding the fact these facilities provide important services to seniors, Medicare needs to find ways to become a more prudent purchaser."
FOCUS OF THE HEARING:
This hearing will focus on the President's fiscal year 1998 budget policies related to rehabilitation facilities and long-term care hospitals in light of the recommendations of the Prospective Payment Assessment Commission, as well as the policies contained in the Medicare Preservation Act of 1995 and the Balanced Budget Act of 1995.
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, Thursday, April 24, 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.