Pending cuts in Medicaid payments to hospitals will hamper hospitals’ ability to care for injured people in the event of a major catastrophe, such as a terrorist attack, according to House Oversight and Government Reform Committee Chairman Henry Waxman (D-Calif.), who held two hearings on the subject in early May. The committee also released the results of a recent survey showing that hospitals in seven cities lack sufficient emergency care capacity to respond to an attack the size of one that occurred in Madrid where nearly 1,000 people needed treatment.
According to a survey of 34 Level I trauma centers, the hospitals did not have sufficient emergency room capacity to treat a sudden influx of victims from a terrorist bombing, the hospitals had virtually no free intensive care unit beds to treat the most seriously injured casualties and the hospitals did not have enough regular inpatient beds to handle the less seriously injured victims. The survey included New York City, Los Angeles, Washington, D.C., Chicago, Houston, Denver and Minneapolis.
Meanwhile, the Department of Health and Human Services has issued Medicaid regulations that will reduce federal funds to public and teaching hospitals by tens of billions of dollars over the next five years, Waxman said. “It appears that Secretary [Michael] Leavitt signed regulations that will take hundreds of millions of dollars away from hospital emergency rooms without once considering the impact on national preparedness,” he said. The earliest cuts would begin May 26, 2008. The House has voted to postpone implementation until April 1, 2009 in order to review the regulations.
Waxman accused Leavitt of ignoring negative public comments on the regulations that the department received before finalizing the rules.
Leavitt said that while hospital capacity for surges is not where HHS would like it to be, HHS is, through the regulations, making sure that states are paying their fair share. “Otherwise, we’re not being a wise steward of limited Medicaid funds,” he said. He explained that hospitals have been taking federal dollars for patient care and putting them in general funds and he said the regulations will ensure the funds are used to treat patients. “This isn’t about trauma centers, it’s about the relationship between the states and the national government,” he said.
If Congress determines there is a need for additional dollars to improve hospital surge capacity, then HHS can direct more funds to the hospitals, Leavitt said. “Medicaid was intended to be for people, not for institutions,” he said. Waxman said that the “tiny grants” to hospitals have not been enough to improve surge capacity.
Source: CCH Washington Bureau, May 8, 2008.
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