Satements on Introduced Bills and Joint Resolutions

STATEMENTS ON INTRODUCED BILLS AND JOINT RESOLUTIONS -- (Senate - January 18, 2007)

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By Mr. CONRAD (for himself, Mr. Hatch, Mr. Wyden, Mr. Vitter, Mr. Dorgan, and Mrs. Lincoln):

S. 338. A bill to amend title XVIII of the Social Security Act to ensure and foster continued patient quality of care by establishing facility and patient criteria for long-term care hospitals and related improvements under the Medicare program; to the Committee on Finance.

Mr. CONRAD. Mr. President, today I am introducing legislation that would take steps to protect access to long-term care hospitals while ensuring that these institutions are admitting the appropriate type of patients. I am pleased to be introducing the bill along with my colleague, Senator Hatch, and I urge my colleagues to consider cosponsoring this cost-saving proposal.

Long Term Acute Care hospitals, or LTAC hospitals, serve a vital role in the Medicare program by providing care to beneficiaries with clinically complex conditions that need hospital care for extended periods of time. These are patients who are too sick to go home or even to a skilled nursing facility, but are stable enough to be released from an intensive care unit. I am happy to have two of these hospitals in North Dakota, one in Fargo and one in Mandan. Together, these two hospitals employ several hundred people and provide care to thousands of North Dakotans. They are a vital part of the North Dakota continuum of care.

While these hospitals provide important health services to very frail individuals, the Centers for Medicare and Medicaid Services (CMS) has become concerned with the growth in these facilities. In 2006, there were 400 LTAC hospitals, compared to 100 in 1996. In addition, the agency has also expressed concern that some LTAC hospitals are admitting patients that may be better served by nursing homes or another level of care. As a result, CMS has begun to arbitrarily cut LTAC hospital payments across-the-board.

As Chairman of the Budget Committee, I have a unique appreciation for the enormous fiscal challenges that face our country and respect CMS's efforts to reduce growth in Medicare. However, any cuts in spending should be targeted at waste and abuse. We should address the growth in LTAC hospitals, but we also want to ensure that there is a place for patients who truly need long-term hospital stays.

The legislation I'm introducing today is a first step in clarifying Congressional intent and giving CMS clearer definitions of what is and is not a LTAC hospital and what type of patient should be admitted to these facilities. At the heart of this bill is a provision that limits the types of patients who can be admitted to LTAC hospitals to those who truly need the specialized care these facilities provide. LTAC hospitals like those in my state that admit only very sick patients will not be significantly affected. But, by eliminating abuses by those facilities that have been receiving generous payments for patients who do not require this sort of specialized care, this provision of the bill would significantly reduce Medicare spending on LTAC hospitals.

It was not easy for the LTAC hospitals in North Dakota and across the country to support legislation that restricts their payments, but I compliment them for working with me to put forward a constructive public policy proposal. In particular, I want to recognize Custer Huseby, Chief Executive Officer of SCCI Hospital in Fargo. He understands that the status quo is no longer defensible and has fought to put forward a workable solution that maintains access to these vital facilities, where they are appropriate. I also want to thank Chip Thomas and Karen Haskins of the North Dakota Healthcare Association, who have partnered with Mr. Huseby to support this legislation.

Long-term care hospitals serve a vital role in our health care system, and we must protect access to these facilities for those who truly need it. But, we can also take responsible steps to ensure that our federal tax dollars are well spent and directed to the most appropriate level of care. I believe my legislation achieves this balance and urge my colleagues to support this measure.

http://thomas.loc.gov/