[Congressional Record Volume 154, Number 24 (Wednesday, February 13, 2008)]
[Extensions of Remarks]
[Page E187]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]


[[Page E187]]
 DIRECT GRADUATE MEDICAL EDUCATION PAYMENTS UNDER THE MEDICARE PROGRAM

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                        HON. BILL PASCRELL, JR.

                             of new jersey

                    in the house of representatives

                      Wednesday, February 13, 2008

  Mr. PASCRELL. Madam Speaker, I rise today to introduce legislation, 
with my friend and colleague Congressman Ron Lewis, which will bring 
equity to an unjust Medicare compensation formula currently used to 
reimburse teaching hospitals.
  Under current law, Medicare uses an antiquated formula to determine 
payments for hospitals with Direct Graduate Medical Education, DGME, 
programs designed to educate and train physicians. The formula, which 
was created in the 1980s no longer serves as an accurate reflection of 
the actual costs of operating training programs in the 21st century.
  Currently, more than 600 hospitals that train physicians are paid 
less than the national average, meaning that Medicare pays less than 
its fair share for the costs of educating doctors in these hospitals. 
In my home State of New Jersey alone, teaching hospitals have lost 
about $6.9 million.
  The current system stymies these hospitals' ability to train a 
workforce sufficient to care for the growing Medicare population.
  Despite congressional efforts in 1999 and 2001 to make incremental 
improvements in DGME payments, hospitals still receive only 85 percent 
of the cost of the national average that teaching hospitals incur today 
for operating costs.
  Bringing the effort to fruition, this legislation requires Medicare 
to at least pay the average cost of operating a training program. It 
would increase the DGME payment--for hospitals whose historical costs 
are less than the national average--to 100 percent of the national 
average per resident amount.
  The floor should be increased to the national average so no hospitals 
receive less than Medicare's fair share of the costs of operating a 
medical education program. This bill does not affect hospitals whose 
historical costs are above the national average.
  I have introduced this measure in the interest of America's 
hospitals, medical students, and the Medicare patients who will one day 
depend on their doctors to have the highest level of training and 
expertise.
  As it stands now, hundreds of teaching hospitals are being reimbursed 
by Medicare at an inadequate level for their work in training America's 
doctors of tomorrow. Too many hospitals, students, and patients are 
depending on us to equip teaching hospitals with the financing they 
need to produce a corps of well trained, experienced physicians.
  Without it, I am concerned that these unsustainable losses are a real 
threat to the future of this nation's healthcare infrastructure.
  I urge my colleagues to join me in cosponsoring this legislation to 
provide a DGME level that accurately reflects of the actual costs of 
operating physician training programs in the 21st century.

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