Chuck Grassley: “today I have introduced the Hospital Transfer Penalty Repeal Act of 1999. This legislation would repeal the Balanced…”

“today I have introduced the Hospital Transfer Penalty Repeal Act of 1999. This legislation would repeal the Balanced Budget Act of 1997 (BBA)'s hospital transfer penalty. This law punishes hospitals that make use of the full continuum of care and discourages them from moving patients to the most appropriate levels of post-acute care. I ask my colleagues to spend a few minutes learning about this issue, because I believe that if they do, they will come to see the need for repeal. The current hospital prospective payment system is based on the average length of stay for a given diagnosis. In some cases, patients stay in the hospital longer than the average and in other cases their stay is shorter. Historically, a hospital has been reimbursed based upon an average length of stay regardless of whether the patient remained in the hospital a day less than the average or a day more than the average. Under the Balanced Budget Act transfer provision, however, this is no longer the case. If a patient in one of ten specified diagnosis-related groups (DRGs) is released earlier than the national average length of stay for that DRG, the hospital does not receive its full prospective payment. Instead, it receives only a smaller per-diem payment. This policy penalizes facilities that transfer patients from the hospital to a more appropriate level of care earlier than the average length of stay.”