[Congressional Record Volume 150, Number 125 (Wednesday, October 6, 2004)]
[House]
[Pages H8253-H8255]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
AMENDING SECTION 340E OF PUBLIC HEALTH SERVICE ACT RELATING TO
CHILDREN'S HOSPITALS
Mr. BILIRAKIS. Mr. Speaker, I move to suspend the rules and pass the
bill (H.R. 5204) to amend section 340E of the Public Health Service Act
(relating to children's hospitals) to modify provisions regarding the
determination of the amount of payments for indirect expenses
associated with operating approved graduate medical residency training
programs.
The Clerk read as follows:
H.R. 5204
Be it enacted by the Senate and House of Representatives of
the United States of America in Congress assembled,
SECTION 1. DISREGARD OF NEWBORN BASSINETS IN CALCULATING CASE
MIX FOR RECEIPT BY CHILDREN'S HOSPITALS OF
FUNDING FOR GRADUATE MEDICAL EDUCATION
PROGRAMS.
(a) In General.--Section 340E(d) of the Public Health
Service Act (42 U.S.C. 256e(d)) is amended--
(1) in paragraph (1), by striking ``related to'' and
inserting ``associated with''; and
(2) in paragraph (2)(A)--
(A) by inserting ``ratio of the'' after ``hospitals and
the''; and
(B) by inserting at the end before the semicolon ``to beds
(but excluding beds or bassinets assigned to healthy newborn
infants)''.
(b) Effective Date.--The amendments made by subsection (a)
shall apply to payments for periods beginning with fiscal
year 2005.
The SPEAKER pro tempore. Pursuant to the rule, the gentleman from
Florida (Mr. Bilirakis) and the gentleman from Ohio (Mr. Brown) each
will control 20 minutes.
The Chair recognizes the gentleman from Florida (Mr. Bilirakis).
General Leave
Mr. BILIRAKIS. Mr. Speaker, I ask unanimous consent that all Members
may have 5 legislative days within which to revise and extend their
remarks and include extraneous material on the bill.
The SPEAKER pro tempore. Is there objection to the request of the
gentleman from Florida?
There was no objection.
[[Page H8254]]
Mr. BILIRAKIS. Mr. Speaker, I yield myself such time as I may
consume.
Mr. Speaker, I rise today in support of H.R. 5204, which would amend
section 340(e) of the Public Health Service Act to modify provisions
regarding the determination of the amount of payments for indirect
expenses associated with operating approved graduate medical residency
training programs. This legislation was introduced by the gentlewoman
from California (Ms. Eshoo), a lady who does so many great things in
the Congress, particularly for her district.
Children's hospitals receive important funding through the Federal
Children's Hospitals Graduate Medical Education, which we call GME,
Payment Program. This funding helps train residents and better enables
children's hospitals to serve all children, regardless their ability to
pay.
Next year, the Committee on Energy and Commerce plans to work to
reauthorize the Children's Graduate Medical Education Program. As
chairman of the Health Subcommittee and a proponent of the children's
hospitals throughout my entire time in Congress, I plan to vigorously
support this reauthorization.
However, while we will be working to reauthorize the program next
year, H.R. 5204 provides a necessary, immediate fix for a small number
of hospitals that treat a disproportionately high number of healthy
infants. Healthy infants. This legislation would allow these hospitals
to receive fair CHGME payments by excluding the number of healthy beds
and bassinets in children's hospitals from the case mix adjustment. By
excluding these healthy beds and bassinets, these hospitals will no
longer be penalized for treating healthy babies.
I urge all my colleagues to support H.R. 5204 today.
Mr. Speaker, I reserve the balance of my time.
{time} 1615
Mr. BROWN of Ohio. Mr. Speaker, I yield myself 2 minutes.
Mr. Speaker, I am pleased to support this legislation and I want to
commend its author the gentlewoman from California (Ms. Eshoo). She has
played a leading role in establishing the successful graduate medical
education program that is the focus of today's bill and a whole host of
other issues.
The Children's Hospital Graduate Medical Education program, known as
Children's GME program, corrected an anomaly in medical education
funding that prevented children's hospitals from establishing medical
training programs for pediatricians and other children's health
specialists, in large part because of the peculiarity of the way we
fund graduate medical education through Medicare.
The legislation of the gentlewoman from California (Ms. Eshoo)
improves that program by ensuring that hospitals with special programs
for certain newborns are not discriminated against in the calculation
of medical education funding. This correction is included in both the
House and Senate versions of GME reauthorization legislation.
I am proud to be the lead Democratic sponsor of this legislation,
along with my colleague, the gentlewoman from Connecticut (Mrs.
Johnson), through H.R. 4578. This legislation before us today provides
an interim solution until the reauthorization bill is written into the
law, and I urge my colleagues to support the bill offered by the
gentlewoman from California (Ms. Eshoo).
Mr. BILIRAKIS. Mr. Speaker, I reserve the balance of my time.
Mr. BROWN of Ohio. Mr. Speaker, I yield 5 minutes to the gentlewoman
from California (Ms. Eshoo), the sponsor of the bill.
Ms. ESHOO. Mr. Speaker, I want to thank my good friend, the gentleman
from Ohio (Mr. Brown), for his leadership as ranking member on this
Subcommittee on Health, which is so important not only here in the
Congress but for our entire country; and to my good friend, the
gentleman from Florida (Mr. Bilirakis), our chairman. Surely we would
not be here this afternoon were it not for his support and pushing to
bring this to the floor so that we can consider it.
What this bill is about, Mr. Speaker, is legislation that is going to
fix a flaw in the Children's Hospital Graduate Medical Education
payment formula. This formula inadvertently penalizes Lucile Packard
Children's Hospital, which is in my district in Palo Alto.
If I just might depart for a moment, Lucile Packard is the mother and
the visionary that established this hospital in Palo Alto. There are
many from across the world and from different parts of the country that
come to have their children cared for there. So I think she is watching
us, and she would be very proud. Were it not for Lucile Packard, as I
said, this hospital would not exist today.
Mr. Speaker, a portion of the Graduate Medical Education calculation
is based on the severity of case mixes. At Lucile Packard Hospital,
which is only one of two hospitals in the United States that offers
pregnancy and healthy newborn services, it is then penalized. Most do
not take care of healthy newborn babies. When they become part of the
mix with the very ill ones, the formula becomes skewed. So if the
hospital did not care for the healthy newborns, we would not be here
today.
The Committee on Energy and Commerce took a look at this to fix it
permanently. As the gentleman stated, that will be taken care of in
2006. Today, we are fixing the small gap between now and 2006. It is
going to go a long way.
I want to reassure my colleagues, there are not any costs associated
with the bill. This is paid for by a reduction in the fiscal year 2005
payment to all hospitals that receive these payments under the program,
and that would not have happened unless the hospitals came together.
And they have endorsed this. There is endorsement from the National
Association of Children's Hospitals, and I want to thank them for
coming together to allow this to happen.
I also want to thank John Ford on the staff of the gentleman from
Michigan (Mr. Dingell) and certainly Chuck Clapton on the staff of the
gentleman from Texas (Chairman Barton), and I want to urge all my
colleagues to vote in favor of H.R. 5204. It is going to help a great
deal, and that help is going to be appreciated not only by the children
and their families, but also the young physicians that have devoted
themselves to a life in medicine; and in this graduate medical payment,
it will enjoy the fullness it should and this will be repaired.
Again, I thank the gentleman from Florida (Mr. Bilirakis), most of
all for his friendship that I have enjoyed and benefited from and am
grateful for since first coming to the House.
Mr. BROWN of Ohio. Mr. Speaker, I yield 2 minutes to the gentleman
from Illinois (Mr. Davis).
Mr. DAVIS of Illinois. Mr. Speaker, I rise in strong support of H.R.
5204 and commend the gentlewoman from California (Ms. Eshoo) for her
sponsorship of this legislation.
I represent a congressional district that has five medical schools
and 28 hospitals, including Children's Memorial in Chicago, which is
one of the best in the Nation. This legislation is going to be very
helpful to several of these institutions.
I simply rise in strong support of this legislation, urge passage,
and commend again the leadership of this subcommittee for its
tremendous activity related to health care and the health care needs of
people in these United States of America.
Ms. JACKSON-LEE of Texas. As one of the co-chairs of the
Congressional Children's Caucus, I urge my colleagues today to support
H.R. 5204, amending section 304e of the Public Health Service Act as it
relates to payments to children's hospitals under the Graduate Medical
Education program.
The existing provisions of the Public Service Health Act unfairly
penalize the two hospitals in the U.S. that offer both pregnancy and
healthy newborn services. This penalty is related to calculation of the
reimbursements that hospitals receive under the Children's Hospital
Graduate Medical Education program (CHGME).
As it is currently configured, the CHGME program calculates payments
to hospitals based on severity of the ``case mix index.'' Healthy
newborns, like those treated in these two hospitals, reduce the
severity of the case mix index and thus the payments to the hospitals.
I believe the current method of calculating these payments is
unreasonable.
[[Page H8255]]
For example, one of the only two hospitals offering healthy newborn
services in the U.S. is the Lucile Packard Children's Hospital. When
healthy newborns are excluded from the calculation, the Packard
hospital has the highest ``case mix index'' of all children's hospitals
in California. With the healthy newborns included, it has the lowest.
In other words, Packard is unfairly denied resources to treat seriously
ill newborns because it also provides services to healthy newborns.
Until the problem is corrected, the Packard hospital will continue to
be shortchanged more than $300,000 each year.
This bill corrects the reimbursement problem faced by these two
hospitals only for fiscal year 2005. Another bill to reauthorize the
Children's Hospital Graduate Medical Education Act, currently on
referral to the Subcommittee on Health, will correct this problem in
fiscal year 2006 and future years. This legislation is needed to
provide relief to the two affected hospitals in fiscal year 2005. This
legislation does not change the eligibility for hospitals to qualify
under the CHGME program.
I believe that it is unreasonable to penalize hospitals offering
services to healthy newborns and urge my colleagues to support this
legislation.
Mr. BROWN of Ohio. Mr. Speaker, I yield back the balance of my time.
Mr. BILIRAKIS. Mr. Speaker, I have no further speakers, and I yield
back the balance of my time.
The SPEAKER pro tempore (Mr. Culberson). The question is on the
motion offered by the gentleman from Florida (Mr. Bilirakis) that the
House suspend the rules and pass the bill, H.R. 5204.
The question was taken; and (two-thirds having voted in favor
thereof) the rules were suspended and the bill was passed.
A motion to reconsider was laid on the table.
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