Riding the coattails of a "must-pass," $29 billion emergency spending package moving through Congress is a potential bounty for some two dozen hospitals in New York and Pennsylvania.
Tucked inside the package, which is likely to be considered after Congress returns from its Memorial Day recess, are provisions that would re-draw the geographical boundaries by which Medicare reimburses hospitals. The realignment ultimately would boost the affected hospitals' Medicare reimbursements by including them in geographical areas, such as New York City, where hospitals already are receiving higher rates, ostensibly because their marketplaces demand they pay higher wages.
In a game of musical chairs, the provisions would realign 10 hospitals in Duchess and Orange counties in upstate New York, which lie in the Newburgh, N.Y., metropolitan area, with hospitals in the higher-paying New York City metropolitan area. Meanwhile, hospitals in five counties in Pennsylvania near Scranton and Wilkes-Barre would be deemed in the higher-paying Newburgh, N.Y., metropolitan statistical area. In Western Pennsylvania, three hospitals in Mercer County near Sharon would be realigned to join the metropolitan area that includes Youngstown, Ohio.
New Jersey hospitals, which have been battling for years to be classified as part of the higher paying New York metropolitan area, are excluded from the provisions, and the New Jersey Hospital Association is "disappointed we're not part of the mix," said Ron Czajkowski, a spokesman for the trade group.
"We've pulled out all the stops on this, and we're going to work the issue right up to the vote," Czajkowski said.
Officials could not say how much money the realignments would mean for the affected hospitals. The provision itself does not affect the overall pot of Medicare money available to hospitals nationwide, but rather shifts money.
The bill to which the proposal has attached itself is a supplemental appropriation that is viewed as a "must pass" in order to carry the nation through the fiscal year to Sept. 30, said Scott Malan, vice president of legislative services for the Hospital & Healthsystem Association of Pennsylvania. The provisions were shifted from the Medicare package when the prescription-drug benefit issue slowed its passage, he added.
Rep. Charles Rangel (D-N.Y.) charged in a written statement last week that GOP leaders were pushing the provisions to help "three politically vulnerable Republican members."
But Malan said the provisions would offer a short-term solution for some "pockets" in Pennsylvania where hospitals are surrounded by competitors lying in a higher wage index area and yet find themselves competing for the same workforce.
"This language reclassifies them to a more appropriate wage area that better reflects the marketplace conditions in which they compete," Malan said. "We see this as a unique situation where there are hospitals that are islands, and the system is not working for them as far as being able to attract healthcare workers."