On May 23, GNYHA met with the chiefs of staff of the NY Congressional Delegation in Washington, and, along with the Healthcare Association of New York State (HANYS), made the case for more relief from the Medicare cuts imposed by the Balanced Budget Act of 1997 (BBA) for hospitals and continuing care providers. At the meeting, which was attended by nearly all the top staff of the members of Congress from across the State, HANYS outlined the need for enacting H.R.3580, sponsored by Congresswoman Nita Lowey (D-NY) and Congressman Jack Quinn (R-NY), which would provide for full inflation or "market basket" updates for hospitals in 2001 and 2002. Under the BBA, hospitals would receive an update of market basket minus 1.1% in those years, denying hospitals a full inflation update for five years running despite the sharply escalating costs of supplies, pharmaceuticals, and other services needed to provide high-quality care for Medicare patients. GNYHA strongly supports H.R.3580.

GNYHA then urged support for S.2394 and H.R.4239, sponsored by Senators Daniel Patrick Moynihan (D-NY) and Charles E. Schumer (D-NY) and Congressman Charles B. Rangel (D-NY), which would halt further scheduled cuts in Medicare payments to teaching hospitals. Under the BBA, the payment rate adjustment teaching hospitals receive to help compensate them for the extra costs they incur for caring for more complex and complicated cases than are treated in non-teaching hospitals -- known as the "indirect medical education adjustment" (IME) -- would be reduced by 29% over five years. Last year, Senator Moynihan and Congressman Rangel succeeded in postponing further reductions for one year; however, the IME adjustment is scheduled to be reduced from a 6.5% increase for every 10% increase in the ratio of interns and residents to beds to 6.25% on October 1, 2000, and to 5.5% on October 1, 2001, imposing an additional $550 million in Medicare cuts to teaching hospitals in NYS over the next five years. Under the Moynihan/Rangel legislation, the IME adjustment would remain at 6.5% permanently, saving teaching hospitals nationwide from another $2 billion in Medicare reductions.

Also at the meeting, GNYHA urged the chiefs of staff to express concern to the U.S. Health Care Financing Administration about the potential impact of changes to Federal Medicaid regulations that could result in a loss of hundreds of millions of dollars in Federal Medicaid funds for NYS annually. GNYHA and HANYS also urged the Delegation to support efforts to mitigate the impact of BBA cuts on continuing care providers.

Reaction: Reflecting the advocacy of GNYHA and its members and the concern of the NY members of Congress for the health care community, the NY Congressional Delegation has been more active than any other delegation on the BBA relief front. The proposals that have garnered support from the nationwide hospital community -- the Moynihan/Rangel IME bill and the Lowey/Quinn update bill -- have been introduced by New Yorkers and enjoy strong support from the Congressional Delegation. At the meeting, GNYHA thanked the chiefs of staff for the support of their respective members of Congress. GNYHA and HANYS suggested that it would be helpful for the Delegation to now meet with the leadership of the House to ensure that BBA relief is enacted this year.