SCHUMER, CLINTON PUSH FOR PASSAGE OF THEIR LEGISLATION TO HALT DEVASTATING HEALTH REGULATION
U.S. Senators Charles E. Schumer and Hillary Rodham Clinton have asked the Senate to pass their new legislation to halt a health regulation that will cause health clinics across Upstate New York to lose a devastating $65 million in critical funding due to a new federal proposal that would reduce federal Medicaid reimbursements to health clinics and hospital outpatient departments.
(Media-Newswire.com) - U.S. Senators Charles E. Schumer and Hillary Rodham Clinton have asked the Senate to pass their new legislation to halt a health regulation that will cause health clinics across Upstate New York to lose a devastating $65 million in critical funding due to a new federal proposal that would reduce federal Medicaid reimbursements to health clinics and hospital outpatient departments. In an effort to ensure that Upstate New York residents continue to have access to essential health care services, Senators Schumer and Clinton introduced the “Preserving Access to Healthcare” ( PATH ) Act of 2008, which includes three significant delays that will help the hundreds of thousands of Upstate New Yorkers who rely on the clinics, hospitals and hospices for necessary health services.
“This inexplicable rule is a punch in the gut to Upstate New York’s health clinics, dialysis centers, dental clinics and so much more,” Schumer said. “We have put on a full-court press to stop this rule. We appealed to the President; called to the agency head administrating this rule; and now we are introducing legislation to put a halt to a devastating regulation change that will cost New Yorkers millions. Make no doubt about it, we will keep pushing and prodding to make sure we protect New York’s health care facilities and the much-needed services they provide.”
“This rule is not only wrongheaded and counter to the mission of Medicaid, it could cost New York millions and force independent clinics to scale back on important healthcare services” said Senator Clinton. “In these difficult economic times the government should be doing all it can to ensure people have access to family planning, school-based heath centers, prenatal care, mental and dental healthcare, and other essential services – but this rule is a roadblock for the people who are most in need. I will continue to fight to see that this absurd rule does not undermine our ability to deliver much needed healthcare services to New Yorkers.”
Last year, the Centers for Medicare and Medicaid Services ( CMS ) proposed a new regulation, the “Medicaid Outpatient Clinic and Hospital Services Rule” that would reduce federal Medicaid funding to states for freestanding health clinics and hospital outpatient departments – such as school-based health centers, children’s hospitals, and clinics that provide dental care, physical therapy, renal dialysis, family planning, mental health and addiction counseling. This rule would drastically change the definition of what outpatient medical services Medicaid will pay for. These changes mean lower or no payment for care like pediatric dental check ups, dialysis for patients with kidney disease, prenatal care and family planning services and preventative care and vaccinations for children.
The proposed rule would reduce the Medicaid payments to New York State by capping them at the Medicare payment amount, which is substantially less ( for most services ) than outpatient facilities currently receive from Medicaid. It also prohibits states from paying more than Medicare pays, even for services that Medicare doesn’t cover. As a result, the rule will lower federal Medicaid funding for New York State and will eliminate federal funding altogether for many important services performed in these clinics, such as dialysis services, psychiatric rehabilitation, family planning services, primary care for children, vision services, dental services and vaccinations.
To ensure Upstate New York health clinics continue to receive this necessary funding and are not forced to slash critical patient services, Schumer personally called CMS Director Kerry Weems last month and demanded an immediate suspension of the proposed rule. Additionally, Senators Schumer and Clinton wrote a letter to President Bush last week to urge his delay of the proposed regulation. The rule has still not been finalized or implemented.
Today, to further ratchet up their efforts to delay the implementation of the rule, Senators Schumer and Clinton introduced the PATH Act to ensure care and treatment for the low-income families that are in greatest need of specialized health care services.
The Schumer-Clinton PATH Act would:
· Put a 6 month delay on the Medicare Hospital Capital IME policy that went into effect on Oct. 1.
· Put a 6 month delay on the Medicaid Outpatient Clinic Rule/7th Medicaid Reg.
· Put a 6 month delay on the Medicare Hospice Rule went into effect on Oct. 1.
· Delay a policy that affects California family planning services
· Delay implementation of rural health clinic and community health center rule.
· Require states to use coding procedures to eliminate fraud and abuse.
· Medicaid Improvement Fund technical correction
The Schumer-Clinton PATH Act will help the over 120 Upstate New York health clinics who rely on the funding to continue services for children, seniors, the disabled, dialysis patients, families struggling with rising costs by blocking implementation of the October 1 Medicare capital Indirect Medical Education ( IME ) cut to teaching hospitals and establish a moratorium on the harmful Medicaid outpatient department and clinic regulation. Without these delays, Upstate New York stands to lose $65 million which could force many of the health clinics and hospitals to cut services and, in some cases, shut their doors.
Below is a region-by-region breakdown of the projected impact of the proposed rule
· In the Capital Region, the rule would slash $10.3 million from 13 clinics.
· In Central New York, the rule would slash $9.6 million from 17 clinics.
· In the Hudson Valley, the rule would slash $20.9 million from 31 clinics.
· In the North Country, the rule would slash $3.7 million from 14 clinics.
· In the Rochester-Finger Lakes, the rule would slash $10.3 million from 25 clinics.
· In the Southern Tier, the rule would slash $1.2 million from 8 clinics.
· In Western New York, the rule would slash $8.6 million from 18 clinics.
The PATH Act will also provide a 6 month delay on a Medicare Hospice Rule that went into effect on October 1. Hospice serves over 1.3 million patients and their families each year, and saves Medicare an average of $2300 per patient. This new rule requires a three-year phase out of the hospice Budget Neutrality Adjustment Factor ( BNAF ), which accounts for the inflation in wages since 1983. This change will mean a significant reduction in reimbursement rates for the majority of hospices in America, making it harder for hospice to continue providing this preferred and cost-effective care. In New York alone, this amounts to a $2.3 million dollar loss in 2009 and a cut of over $26 million over the next 3 years. Senators Schumer and Clinton are co-sponsors of the Medicare Hospice Protection Act, introduced by Senators Specter and Harkin, which would delay this cut for a year.
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