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By M. PAUL JACKSON [email protected]
Wednesday, November 19, 2003     Page: 1C

WILKES-BARRE – The proposed Medicare bill working its way through Congress
could bring up to $6 million more in federal reimbursement to Northeastern
Pennsylvania hospitals, a Wilkes-Barre hospital official said.
   
But the figure is still less than hospitals in more urban areas could
receive under the bill, said Dr. William Host, president of the Wyoming Valley
Health Care System.
    The Medicare bill, which a legislative analyst said might pass by
Thanksgiving, would include a long-awaited prescription drug benefit for
seniors. The bill also would bring in up to $300 million into Pennsylvania
hospitals during a five-year period, by restructuring two portions of the
current Medicare laws.
   
Under the plan, the bill would standardize how hospitals are reimbursed, as
well as reduce the importance of wage payments in calculating reimbursement
levels.
   
“There’s a sense of momentum” in Washington D.C. about passing the bill,
said Scott Maylan, federal lobbyist for the Hospital and Healthsystem
Association of Pennsylvania, the state’s hospital trade group.
   
Medicare is a federal program that reimburses hospitals and physicians for
medical services for the elderly and disabled.
   
Under the bill, all state hospitals would be standardized under the same
urban reimbursement system, Maylan said.
   
Currently, hospitals in rural areas are reimbursed at a lesser rate than
hospitals in larger areas, despite spending the same on health-care costs. The
discrepancy has long raised a cry from local hospital officials.
   
In addition, the bill would change the “wage index” reimbursement system
now used by the government. Generally, the reimbursement is based largely on a
“wage index” formula, or the average health-care wages of a region.
   
Medicare assigns about 71 percent of that formula to an area’s average
health-care wages. Under the new bill, the formula will reduce the “weight”
of the health-care wages to about 62 percent.
   
The reduction will make hospitals a little less dependent on health-care
wages for their Medicare reimbursements, although larger hospitals could still
receive more, officials said.
   
“If you’re in a low-cost area, that helps you,” Maylan said.
   
The Medicare bill is intended to provide prescription drug benefits to
about 41 million people. Medicare currently does not have a drug benefit,
forcing seniors or the disabled to seek a Medicare supplement plan instead.
   
The bill could bring between $22 billion to $25 billion in additional
Medicare funds into the country’s hospitals during a 10-year period, Maylan
said.
   
In the past, Northeastern Pennsylvania health-care leaders have argued that
the area be “attached” to the wage index system of other, larger areas.
   
Last year, the U.S. Senate killed a bill that some legislators said could
have brought about $39 million into the area.
   
The area’s hospitals could have received millions more in funding if small,
rural hospitals were brought completely in line with the reimbursement system
used in larger areas, Host said.
   
Larger, more urban areas such as the Lehigh Valley could receive about $18
million more in additional funding, he estimated. Still, he said the new bill
was an important first step.
   
“It’s a significant help. People ought not to be looking this horse in the
mouth.”
   
M. Paul Jackson, a Times Leader staff writer, may be reached at 829-7134.