Letters Circulate on Medicare
IME, Medicaid DSH and Other Provider Issues
July 25, 2003 - Members of Congress are actively circulating
"Dear Colleague" letters in an attempt to influence
the Medicare Conferees. In the House, Rep. Chris Shays (R-Conn.)
is pursuing restoration of Indirect Medical Education (IME)
payments to 6.5 percent, and members of the Blue Dog coalition
are supporting additional provider adjustments. The California
delegation and a bipartisan group of four Senators are pushing
efforts on behalf of Medicaid Disproportionate Hospital (DSH)
provisions.
Rep. Shays is circulating for House Republican signatures
a letter urging the House Medicare conferees to improve upon
the Senate's IME provisions and restore the Medicare IME payment
to 6.5 percent. As of July 23, the following 25 Republicans
have signed onto the Shays letter: Charlie Bass (N.H.), John
Duncan (Tenn.), Jo Ann Emerson (Mo.), Phil English (Pa.) Vito
Fossella (N.Y.), Jim Gerlach (Penn.), Jim Greenwood (Pa.),
Melissa Hart (Pa.), Bill Janklow (S.D.), William Jenkins (Tenn.),
Tim Johnson (Ill.), Peter King (N.Y.), Ray LaHood (Ill.),
Steve LaTourette (Ohio), Jim Leach (Iowa), Thaddeus McCotter
(Mich.), Tim Murphy (Pa.), Charlie Norwood (Ga.), Mike Rogers
(Mich.), Todd Platts (Pa.), Jack Quinn (N.Y.), Chris Smith
(N.J.), John Sweeney (NY), Fred Upton (Mich.), and Jim Walsh
(N.Y.).
All but two of California's 53 House members signed a July
15 letter to the conferees urging that the final product include
the Medicaid DSH provisions in H.R.
1. The letter calls the state's healthcare safety net
a "vital concern to the entire California delegation."
It adds that the "drastic payment reductions absorbed
this year … threaten access to necessary health services
for Medicaid recipients, the uninsured, and indeed, all Californians."
Because of his role as House Conferee Co-Chairman, Bill Thomas
(R-Calif.) did not sign the letter; Rep. Wally Herger (R-Calif.)
was the other delegation member not signing the letter.
In the Senate, Senators Michael Enzi (R-Wyo.), Lincoln Chafee
(R-R.I.), Jeff Bingaman (D-N.M.) and Bob Graham (D-Fla.) are
circulating a letter to the Medicare bill conferees in support
of two provisions related to the Medicaid DSH program. This
letter urges conferees to accept H.R. 1's provision for DSH-cliff
hospitals, and S. 1's provision to provide relief for low-DSH
hospitals.
Also, on July 21 a coalition of 28 "Blue Dogs,"
conservative House Democrats, wrote a letter aligning themselves
with a number of provisions that were included in the Senate
Medicare prescription drug bill. Included in their list of
issues "critical" to their "support for a prescription
drug benefit" legislation are provider adjustments. Referring
to the fact that both House and Senate bills contain "strong
rural packages," the letter "encourages the conferees
to maintain at least these levels of funding." "Further,"
states the letter, "we strongly oppose a measure that
cuts the hospitals market basket rate or home health payments,
or fails to address the needed adjustments to our DSH payment
rates."
Information:
Lynne Davis Boyle, Assistant Vice President
AAMC Government Relations
ldavisboyle@aamc.org
(202) 828-0526
Christiane Mitchell, Senior Legislative Analyst
AAMC Government Relations
cmitchell@aamc.org
(202) 828-0526
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