Wednesday, January 4, 2006
Congress Nearing Final FY 2006 Budget
The federal government continues finalizing the fiscal year 2006 budget, with the legislation expected to be finished when Congress returns to session Jan. 31. In December, House and Senate conferees agreed on a budget package, which was passed by the House but changed by the Senate. The package returned to House, where swift passage is expected, and it should be enacted officially by early February.  Some of the key provisions that impact hospitals include:

• Full updates for Medicare inpatient and outpatient payment rates.
• A moratorium on new limited service specialty hospitals for up to eight months as the U.S Department of Health and Human Services develops policy suggestions to Congress regarding physician investment, charity care, and other guidelines for such facilities.
• Cuts to ambulatory surgical centers, bringing their payments in line with hospital outpatient departments.
• A second year phase-in at 60 percent to the Rehabilitation 75% Rule before continuing to 65 percent in 2007 and 75 percent in 2008.
• For rural facilities: An extension of the outpatient hold harmless provision for three years, at 95 percent the first year, 90 percent the second and 85 percent the third year; a provision to rebase and extend the Medicare Dependent Hospital program until 2011.
• Allowing children’s hospitals to participate in the 340B program to purchase drugs at a discount.
• A freeze in Medicare physician payments for one year, rather than allowing a scheduled 4.4% cut.
• An overall Medicaid net cut of $4.7 billion over five years, significantly less than proposals made by fiscal conservatives earlier this year.

Despite hospital lobbying efforts, the package retained a provision regulating the rate out-of-network hospitals and their emergency departments are paid by Medicaid managed care plans and some cost-sharing for Medicaid enrollees. Effective in FY 2007, the bill would also expand quality reporting requirements and increase the penalty to Market Basket minus 2.0 for hospitals not reporting all required categories.

Also on the national front, Congress approved the 2006 Labor, HHS and Education appropriations bill with $90 million more for rural health programs than a previous version. Congress also approved $3.1 billion for pandemic flu preparedness activities in the Department of Defense appropriations bill. (Jonathan Archey, jonathana@ohanet.org)

Hospitals’ Heartbeat
A 2005 nominee for the Albert E. Dyckes Health Care Worker of the Year Award

Colegate Bell, RN
Western Region Perinatal and Parenting Education Manager, Childbirth/Childcare Education        
Fairview Hospital, Cleveland
Photo

A look inside Colegate’s nomination –
Coe Bell has a rich professional history as a registered nurse in women’s and children’s health.  She has served as a neonatal intensive care staff nurse, a neonatal case manager, a lactation consultant, a quality assurance data collector and manager of our Childbirth/Childcare Education program.  Coe and her staff are often a young family’s first contact with Fairview Hospital.  She has created an effective “front door” for our family centered obstetrics program by introducing families to their choices, involve them in their decisions, and provide them with honest communication, information and support.  As a leader she demonstrates to her staff the program’s core value that the family is a partner with health care professionals for the purpose of enhancing family strengths, competence and self-reliance.