U.S. Rep. Kevin Brady (R-Texas) put forth a bill on the House floor this week that would strike a part of the Patient Protection and Affordable Care Act related to hospital wage-indexing that has led to hospitals in some states capturing a much larger share of certain Medicare payments than more rural states.
The Medicare Hospital Wage Index Equity Act of 2013 would effectively overwrite the rural floor provision of the hospital wage index under Medicare, requiring urban hospitals to pay workers at least as much as rural hospital wages.
CMS index payments used to be budget-neutral for each state, but in 2010 the PPACA made those indexes applicable nationwide. That meant the pool of wage-index adjustment money could now disproportionately be used to pay higher payments to rural hospitals in states with more urban hospitals, leaving less for rural hospitals elsewhere.
In a release, Rep. Brady slammed the so-called "Bay State Boondoggle," a controversy uncovered earlier this year regarding a situation in Massachusetts in which the state's only rural hospital — located in the affluent Nantucket region — helped drive all other Massachusetts hospitals' Medicare wage reimbursements up. "Last year local hospitals in 40 states lost $471 million," Rep. Brady said in the release. "It's time to stop rewarding one state at the expense of all the others."
Twenty state hospital associations and the National Rural Health Association have opposed the index payment change under the PPACA, and U.S. Sens. Claire McCaskill (D-Mo.) and Tom Coburn, MD (R-Okla.), passed an amendment to the Senate budget that would undo the change if approved in both chambers.
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The Medicare Hospital Wage Index Equity Act of 2013 would effectively overwrite the rural floor provision of the hospital wage index under Medicare, requiring urban hospitals to pay workers at least as much as rural hospital wages.
CMS index payments used to be budget-neutral for each state, but in 2010 the PPACA made those indexes applicable nationwide. That meant the pool of wage-index adjustment money could now disproportionately be used to pay higher payments to rural hospitals in states with more urban hospitals, leaving less for rural hospitals elsewhere.
In a release, Rep. Brady slammed the so-called "Bay State Boondoggle," a controversy uncovered earlier this year regarding a situation in Massachusetts in which the state's only rural hospital — located in the affluent Nantucket region — helped drive all other Massachusetts hospitals' Medicare wage reimbursements up. "Last year local hospitals in 40 states lost $471 million," Rep. Brady said in the release. "It's time to stop rewarding one state at the expense of all the others."
Twenty state hospital associations and the National Rural Health Association have opposed the index payment change under the PPACA, and U.S. Sens. Claire McCaskill (D-Mo.) and Tom Coburn, MD (R-Okla.), passed an amendment to the Senate budget that would undo the change if approved in both chambers.
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