Members of Tennessee's congressional delegation are requesting an extension of federal funds to help hospitals care for tens of thousands of low-income patients while they seek a permanent solution to a problem that is unique to the state.
All states participate in the funding program, known as the "disproportionate share hospital" fund, or DSH, the Chattanooga Times Free Press reported. But because of the wording of a 1994 waiver that created TennCare — the state's version of Medicaid — Tennessee is now the only state that requires a year-by-year renewal of a program that hospitals say is crucial to their bottom line.
Nine Tennessee lawmakers are appealing to federal officials for the funding extension.
They say the extension is needed "to prevent any lapse in funding" that would threaten hospitals while the lawmakers seek "a permanent solution in the next Congress." Their request came in a recent letter to Marilyn Tavenner, administrator for the CMS.
In the letter, lawmakers wrote that "we are deeply committed to restoring Tennessee's DSH funding, as our state is the only one in the nation without permanent access to these dollars."
The letter was signed by U.S. Sens. Lamar Alexander and Bob Corker, along with U.S. Reps. Diane Black, Chuck Fleischmann, Marsha Blackburn, Steve Cohen, Jim Cooper, John Duncan Jr. and Phil Roe.
"Tennessee hospitals are an integral part of their communities, providing $950 million in charity care and $720 million in unreimbursed costs in 2013," the letter said. "Despite the looming financial uncertainty, our hospitals have continued to provide quality care for our state's most vulnerable populations."
Rep. Scott DesJarlais, a South Pittsburg physician, and Rep. Stephen Fincher, a West Tennessee businessman, did not sign the letter, the newspaper reported.
Because of the year-by-year renewal, Tennessee hospitals feel fresh anxiety every year that the funding will lapse. In 2013, when the government shut down in October, Tennessee's DSH program was not renewed, throwing the state's hospitals into turmoil over the possible loss of millions in funding.
For Erlanger Health System, the loss of the funding added to the decision to freeze employees' vacation time this spring as the hospital faced the possibility of ending the year in the red, the newspaper reported.
"The disproportionate share funding is critical to Erlanger and other hospitals who serve those with the greatest need," said Steve Johnson, Erlanger's vice president of payer relations. He said the hospital takes in about $10 million in DSH money annually.
The funds eventually were restored through a temporary federal administrative "patch" in April.
Lawmakers hope to prevent such upheaval from happening again. But finding a permanent fix has not been easy. Such a bill would carry a much heftier price tag than a year-by-year renewal.