Late
BBA deal nets $11.5 billion in givebacks 
by
James M. Berklan
Hospitals headed into 2001 with an $11.5 billion smile on their faces
thanks to a late compromise between Congress and the Clinton Administration
on Medicare givebacks. Many of the provisions will kick in April 1.
Lawmakers
provided full inflation funding to cover inpatient costs for 2001. Hospital
lobbyists had sought a second year at the full inflation rate. Instead
the second year was given a rate of 0.55% below the inflation marker,
half the minus-1.1% level called for in the Balanced Budget Act of 1997.
It was the second straight year Congress came through with major relief
for providers. But with a major player, the Federation of American Hospitals,
Washington, saying it wouldn't come banging the Medicare relief cup
before Congress again next year, it might be the last. Last month's
action brings $35 billion in increased spending for Medicare, Medicaid
and state children's health insurance programs over five years.
Rural hospitals were big gainers, netting $1.8 billion for disproportionate
share (DSH) payments. More than $1.2 billion goes toward elimination
of Medicaid DSH cuts scheduled for fiscal years 2001 and 2002, along
with an increase in allotments in some states.
"It's
a very good sweetener for those of us who live in rural America who
were mostly, but not totally, satisfied with the original bill," said
Sen. Charles Grassley (R-IA).
Teaching hospitals, skilled nursing facilities and long-term care hospitals
also will receive significant boosts under the Benefits Improvement
and Protection Act of 2000 (BIPA).
HPN
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