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Archive for Sunday, April 29, 2007

Kansas hospitals could lose funds if Bush vetoes bill as promised

April 29, 2007

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Tucked away at the bottom of Congress's Iraq war supplemental spending bill is an amendment that has the potential to prevent Kansas hospitals from losing between $17 million and $30 million in federal funding.

While hospital administrators are appreciative of the amendment, they're doubtful the provision will become law - President Bush has vowed to veto the entire bill because it contains a timetable for withdrawing troops from Iraq.

A proposal being developed by the Centers for Medicare and Medicaid services would cut federal funding for graduate medical education. The administration has argued that Medicaid is not an appropriate vehicle for funding medical education. The cuts would save the administration an estimated $1.7 billion nationwide but could prove costly to hospitals that say they already lose money for providing educational opportunities for Kansas medical residents.

The three hospitals in Kansas that receive medical education funding from Medicaid include Kansas University Hospital in Kansas City, Kan., and Wesley Medical Center and Via Christi Regional Medical Center, both in Wichita. KU Hospital could lose about $10 million in funds if the proposal goes through, while the combined effect would be about $7 million for the hospitals in Wichita, said Megan Ingmire, a spokeswoman for the Kansas Health Policy Authority, which oversees Medicaid in Kansas.

"Medicaid GME is a federal match program," Ingmire said. "State funds compose 40 percent and federal funds 60 percent of GME payments to those hospitals."

KU's stance

At KU Hospital, payments to residents provided by the KU School of Medicine are at the center of a dispute over a proposed affiliation with St. Luke's Hospital in Kansas City, Mo. The medical school says it should be paid more for the residents, while KU Hospital says an affiliation with St. Luke's, a competitor, dilutes the KU brand.

Dennis McCulloch, KU Hospital spokesman, said it's hard to determine what sort of effect the cuts might have because the hospital negotiates a specific rate for Medicaid services with the state of Kansas and in so doing doesn't get a specific line item for medical education funding. He added that total exposure to the hospital, however, could top $20 million, according to internal estimates.

"Certainly, a significant reduction would have to be figured into the rate we're negotiating with the med school," McCulloch said.

Lobbying efforts

McCulloch said KU Hospital has been working with the Association of American Medical Colleges to educate congressional leaders on how costly this proposal could be.

The AAMC has sent several letters to members of Congress, imploring that they support the proposed amendment to prevent cuts to medical education.

In an April 23 letter to the majority and minority leaders, the AAMC urged them to support legislation that would "halt development of the proposal to eliminate graduate medical education funding in order to protect safety net hospitals."

McCulloch said the Kansas congressional delegation, both Democrat and Republican, has been very supportive of the hospital's position.

Effects in Wichita

In Wichita, Via Christi already loses nearly $6 million per year on its program to educate medical residents, said hospital chief financial officer Mike Wegner. The hospitals in Wichita also need to add at least $6.5 million worth of new faculty and facilities in order to maintain accreditation, Wegner said.

Kansas House members recently added $6.6 million to the budget to pay for those needs.

"The doctors we train (in Wichita) are a lot of the doctors who stay in Kansas," Wegner said. "These cuts would have substantial impact on our ability to operate this program."

Wegner also said he thought Medicaid was "absolutely an appropriate vehicle" for funding graduate medical education.

Penny Vogelsang, chief operating officer of the KU School of Medicine in Wichita's graduate medical education program, said a loss in any funding could have a tremendous effect on the school's ability to educate its 270 residents.

Reaction

U.S. Rep. Dennis Moore, a Democrat whose district includes KU Hospital, said funding for graduate medical education is a crucial part of improving access to health care for all Americans that must not be curtailed.

U.S. Rep. Todd Tiahrt, a Republican whose district includes the two Wichita hospitals, is opposed to the administration proposal, according to a spokesman.

"The congressman opposes this effort not only because of the impact it would have on hospitals in Wichita, but also the impact it would have on KU Medical Center," spokesman Chuck Knapp said.

Representatives from the Centers for Medicare and Medicaid Services, which would implement the rule change, did not reply to several requests for comment for this article.

Comments

ASBESTOS 7 years, 4 months ago

Sorry but the spending measure IF NECESSARY should have been in it's own bill, not tacked onto another non related bill. How is funding hospitals even remotely related to the war funding?

The reporter and the paper dishonestly implies the funding of hospitals will revlove around the bill being vetoed. IT SHOULD HAVE NEVER BEEN THERE in the first place!!! This war funding bill was LOADED with pork, that is how they got it passed in the first place, by quid pro quo in giving money to representaqtives and states to support passage of this bill.

IT is agreat example of what is wrong with our elected representatives taking what amounts to bribes.

"While hospital administrators are appreciative of the amendment, they're doubtful the provision will become law - President Bush has vowed to veto the entire bill because it contains a timetable for withdrawing troops from Iraq."

They HAVE to veto "the whole thing",... there is no line item veto!!!!

Do some reporting and some research BEFORE printing the story (lie, propaganda).

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oldgoof 7 years, 4 months ago

asbestos. Take a chill pill. The newspaper, reporters, or university did not draft this appropriation. Your shrill comments here reinforces my suspicion of you naitivity about how government works, including KDHE and EPA, or journalism and reporting for that matter. There has been copious reporting about other programs included in this defense bill. Expenditures for graduate medical education are not pork, but programmatic. The LJW will be the only newspaper in the state which will even pick up on this wrinkle, which is huge for the University of Kansas Medical Center, and the Hospital Authority, as well as the two hospitals in Wichita. The article does not dishonestly infer anything, but describes a real issue in a real bill.

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oldgoof 7 years, 4 months ago

KU Hospital spokesman says: "Certainly, a significant reduction would have to be figured into the rate we're negotiating with the med school," McCulloch said. . Great. KU Hospital again publicly threatening to screw the University. And people wonder why the Chancellor and Provost and Governor are trying to gain a bit of traction in negotiations with this entity. . The real issue here is that 99.99% of the population do not understand how graduate medical education is financed, and that the federal government has been the major underwriter of this training, and is slowing but surely removing this support.....which has huge implications to the states and to the practice of medicine in general. Stay tuned, because people will be hearing more about this issue in the future. It is huge.

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ASBESTOS 7 years, 4 months ago

Oldgoof does not understand this was A WAR SPENDING BILL!!! Idiot! THis is not the "Gratuate MEdical Funding" bill. This was "Pork" added to get votes.

You must want/need the money or are affiliated with someone who does want it!

And the newspaper IS dishonest stating that:

"While hospital administrators are appreciative of the amendment, they're doubtful the provision will become law - President Bush has vowed to veto the entire bill because it contains a timetable for withdrawing troops from Iraq."

THERE IS NO LINE ITEM VETO!!!!!!!

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oldgoof 7 years, 4 months ago

Asbestos... here you go again name calling. Hope it makes you a bigger man. I am not here to justify the purity (defense-only) or non purity (pork or programs) of this or any other federal appropriations language. But it is very common. And it is what it is. There were other things added to this approps, bill and yes probably to attract political support. But nowhere does the constitution or federal law prohibit congress from mixing issues, despite your desires for a more perfect political science world. It happens in every approps bill. So it is what it is. And the article describes the issue accurately. If that makes the paper dishonest and me an idiot, so be it. I think it again shows your stark naive understanding of government, and your mean personal nature.
. And I have no personal connection to the issue. Unlike your interest in.....asbestos.

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Christine Pennewell Davis 7 years, 4 months ago

The only thing I can say is someone wanted this money to be vetoed or there is no way they would have attached it to a bill they knew would be vetoed, shame shame shame.

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ASBESTOS 7 years, 4 months ago

That is the dishonest portion of this reporting that I was trying to point out there momma.

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Godot 7 years, 4 months ago

I agree with momma and Asbestos. I think the Dems threw everything they could on the Iraq war bill so they could have more things to blame on Bush.

Why is funding for training physicians tied to Medicare and Medicaid? That's convoluted.

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oldgoof 7 years, 4 months ago

If vetoed, this item of money can be placed in other subsequent bills. It was probably placed in this defense approps either because of an urgent timing issue, or in order to obtain more political support for the bill's original passage. This is appropriations bill writing 101. Regardless, there is nothing inaccurate or dishonest in the reporting.

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oldgoof 7 years, 4 months ago

It appears that this item was placed into the bill with a number of items which were deemed as emergencies since they are needed in this fiscal year. (2007) Read here for medical related issues: http://www.aamc.org/advocacy/library/washhigh/2007/042707/start.htm#1

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oldgoof 7 years, 4 months ago

Godot, considerable federal support for graduate medical education are tied to patient care, hence medicaid mechanism.

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ASBESTOS 7 years, 4 months ago

"Godot, considerable federal support for graduate medical education are tied to patient care, hence medicaid mechanism."

And "hence" not defense or war effort funding.

"It appears that this item was placed into the bill with a number of items which were deemed as emergencies since they are needed in this fiscal year."

Based on what evidence, the old dummy?

"If vetoed, this item of money can be placed in other subsequent bills. It was probably placed in this defense approps either because of an urgent timing issue, or in order to obtain more political support for the bill's original passage. "

Yes the last statement "order to obtain more political support for the bill's original passage." Yes, buying support for a defense spending bill in order to blame more things on Pres. Bush.

That is the dishonest part, and NO there should be NO medical or meidcaid in "defense spending or appropriations".

Ever hear of misappropriated money? That is why they have to b in different bills. As you said :

"This is appropriations bill writing 101." And you cannot co mingle money or taxation.

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oldgoof 7 years, 4 months ago

asbestos: Sorry that congress has put multiple issues in a single bill. Run for office. But until then try to read up. It will help you perhaps make a cogent point. By the way, what is the title of the bill: It Isn't "the Iraq war bill" or "the defense bill." It is "Making emergency supplemental appropriations for the fiscal year ending September 30, 2007, and for other purposes" Also commonly called the "Emergency Supplemental." Therefore it can and does contain all subject matters...as it regularly does on a virtual annual basis. Get some facts, dude. See: http://thomas.loc.gov/cgi-bin/bdquery/z?d110:h.r.01591:

"

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Godot 7 years, 4 months ago

Separate the cost of training physicians from the cost of providing medicare and medicaid. How can anyone know what the real costs are if these are all lumped together?

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oldgoof 7 years, 4 months ago

Godot: Good idea. Already done. Medicare reimbursements for services are separate from graduate medical education subsidies. They are not part of rate structure, but are separate allocations to hospitals based on volume of actual patient care reimbursements.

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