Arlen Specter: “I rise today to raise a very important issue concerning the vital safety-net hospitals in my state of Pennsylvania. As…”

“I rise today to raise a very important issue concerning the vital safety-net hospitals in my state of Pennsylvania. As my colleagues are aware, the Medicare Disproportionate Share Hospital program consists of special supplemental payments made to hospitals to offset the costs for providing uncompensated care. I worked closely over the last few years with Pennsylvania hospitals and the Health Care Financing Administration to resolve a dispute concerning the inclusion of a State's General Assistance population as a part of its Medicare Disproportionate Share Hospital (DSH) payment calculation. In August 1998, HCFA asserted that Pennsylvania hospitals were incorrectly including General Assistance (GA) days in their Medicare DSH calculation, and claimed that they should only have included Medicaid days. These payments represent a significant portion of many hospitals' revenues, and any proposed reduction puts the Commonwealth's neediest populations at risk. The dispute raised further concerns about how HCFA interpreted its own rules and regulations. Medicare fiscal intermediaries had been reimbursing hospitals with the GA days included for the past twelve years. Yet, beginning in mid-1998, HCFA reversed its own intermediaries' interpretation and began recouping the so-called overpayments for certain years, as far back as fiscal year 1993. The impact to Pennsylvania's hospitals would have totaled in the hundreds of millions of dollars.”