[Congressional Record Volume 144, Number 118 (Wednesday, September 9, 1998)]
[Extensions of Remarks]
[Page E1668]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




   STOPPING ABUSE OF MEDICARE LONG TERM CARE HOSPITAL PAYMENT SYSTEM

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                        HON. FORTNEY PETE STARK

                             of california

                    in the house of representatives

                      Wednesday, September 9, 1998

  Mr. STARK. Mr. Speaker, I am introducing legislation today to close a 
loophole in the way Medicare pays long-term care hospitals--hospitals 
which treat people with severe problems and which have an average 
length of stay (ALOS) of more than 25 days.
  Some so-called TEFRA hospitals establish extremely high patient costs 
in the first year or two of operation, which establishes the rate at 
which they will be paid under Medicare in future years. Once that rate 
is established, they immediately go to a much lower cost mix of 
patients, but get paid as if they still had a very sick, expensive 
patient caseload. The bill I am introducing would help curb this gaming 
of the system.

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