[Congressional Record (Bound Edition), Volume 151 (2005), Part 20]
[Extensions of Remarks]
[Page 27214]
[From the U.S. Government Publishing Office, www.gpo.gov]




                       GRADUATE MEDICAL EDUCATION

                                 ______
                                 

                             HON. RON LEWIS

                              of kentucky

                    in the house of representatives

                      Thursday, November 17, 2005

  Mr. LEWIS of Kentucky. Mr. Speaker, I am introducing today 
legislation to address longstanding inequities in Medicare's payments 
for graduate medical education.
  More than 600 hospitals across the country, many in my home state of 
Kentucky, receive less than the national average from Medicare to train 
and educate physicians. Medicare's formula for paying hospitals that 
operate teaching programs is based on costs reported in the early 
1980s, significantly below current costs and expanded needs. This 
limits the ability for many hospitals to train a workforce sufficient 
to care for the growing Medicare population.
  In my state, teaching hospitals lose more than 2 million dollars a 
year as a result of Medicare's dated policy. In neighboring Ohio, 
Medicare's policy shortchanges hospitals more than $10 million each 
year. My bill will increase Medicare's Direct Graduate Medical 
Education (DGME) payments to hospitals to 100 percent of the national 
average per resident amount for facilities whose historical costs are 
less than the national average.
  Congress has made incremental improvements to DGME payments 
throughout the past 6 years. This began in 1999 with the implantation 
of a 70 percent minimum payment. In 2001, payments were raised to 85 
percent of the national average. In the Medicare Modernization Act of 
2003, Congress again recognized the flaws in Medicare's payments to 
teaching hospitals by including a provision requiring that any resident 
positions redistributed to other hospitals be reimbursed at 100 percent 
of the national average. My bill continues this work by requiring 
Medicare to at least pay the average cost of operating a training 
program.
  Medicare's Direct Graduate Medical Education payments 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.

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