Senate amendments address health centers, ER crowding

Federally qualified health centers would move toward a prospective payment system for the Medicare-covered services they provide and HHS would form a task force to help alleviate overcrowding in the nation's emergency rooms under measures attached to a major health reform bill being shaped in the Senate Finance Committee.

Federally funded health centers were established to treat mostly poor patients in areas where medical facilities are scarce. They often provide preventive and primary healthcare services and have been shown to do so with a high level of quality and satisfaction.

Early on, Congress required health centers to be paid at a rate that guaranteed that they would not lose money serving Medicare patients and have to tap into the grant dollars that subsidize their operations.

In 1992, federal regulations capped how much Medicare can pay health centers for certain services. While the cap has increased, the cost of care for seniors has increased faster. Nearly 75% of health centers have taken a financial hit because of the cap, with average losses of about $85,000 and total losses exceeding $51 million, according to Sen. Jeff Bingaman (D-N.M.), who offered the amendment.

Starting in 2012 a permanent payment system would be created based on the existing one for health centers in Medicaid and a federally backed children's health program. The provision also would cover preventive and primary care services.

Meantime, the committee also agreed to a an amendment by Sen. Debbie Stabenow (D-Mich.) that requires HHS to establish a group of industry experts that would develop a framework to unclog hospitals' often crowded emergency departments.

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