A bill to establish a transitional system of hospital cost containment by providing for incentives and restraints to contain the rate of increase in hospital revenues, to establish a system of capital allocation designed to encourage communities to avoid the creation of unneeded and duplicative hospital facilities and services, to provide for the publication and disclosure of information useful to the public in making decisions about health care, to provide for the development of permanent reforms in hospital reimbursement designed to provide incentives for the efficient and effective use of hospital resources.
Hospital Cost Containment Act - Title I: Transitional Hospital Cost Constraint Provisions - States that it is the purpose of the program established by this title to constrain the rate of increases in total acute care hospital inpatient costs. States that the increase in total revenue which a hospital may receive in any accounting year in the form of: (1) reimbursement paid under the Medicare and Medicaid programs, and by cost payers for inpatient services; and (2) charges imposed upon other persons for inpatient services; and (2) charges imposed upon other persons for inpatient services, may not, on a per admission basis, exceed the average inpatient reimbursement due or inpatient charges imposed per inpatient admission in the base period by more than the percentage allowed under this Act.
Sets forth formulas by which the limits of the increase in total revenue may be computed. Bases the "inpatient hospital revenue increase limit" on increases in the gross national product deflator and total hospital expenditures nationwide.
Excepts from such limits hospitals which are experiencing substantially higher costs as a result of extraordinary changes in patient loads or major changes in facilities and services.
Directs the Secretary of Health, Education, and Welfare to promulgate the inpatient hospital revenue increase limit applicable during a 12-month period beginning on October 1 of each year.
Directs the Secretary to promulgate a formula for adjusting such revenue increase limit based on the number of admissions during a 12-month accounting period.
Authorizes the Secretary to grant exceptions to the revenue increase limit during periods in which the excepted hospitals meet specified criteria. Permits any hospital which is dissatisfied by the decision of the Secretary to grant or not grant an exception if the amount in controversy is $25,000 or more, to obtain a hearing before the Provider Reimbursement Review Board established by the Social Security Act. Directs the Secretary to appoint five additional members to such Board for the purpose of reviewing appeals under this title.
Prohibits, under the Social Security Act, the payment of hospital costs in excess of the limits established pursuant to this Act. Prohibits the receipt by any hospital, or payment by any cost payer for inpatient hospital services on a cost basis in excess of applicable limits. Subjects hospitals or cost payers in violation of such prohibitions to: (1) a Federal excise tax established by this Act; and (2) exclusion from participation in any of the programs established under the Medicaid, Medicare or Maternal and Child Health Services programs of the Social Security Act.
Allows the Secretary to exclude from cost containment provisions: (1) hospitals meeting specified criteria located in a State at the request of the Governor of such State: and (2) hospitals engaged in certain experiments on demonstrations authorized by the Social Security Act.
Requires every hospital to submit seminannually to the appropriate health systems agency, its average semiprivate room rate and the charges for ten other representative services most important for purposes of comparing hospitals.
Amends the Internal Revenue Code of 1954 to impose an excise tax on payments received for inpatient hospital services in excess of the inpatient hospital revenue increase limit.
Establishes a system of incentive payments for hospitals which recognize an increase in the cost per inpatient admission which is less than the limit allowed for such increase.
Title II: Limitation on Capital Expenditures - Amends the Public Health Service Act to require the Secretary to promulgate: (1) an annual hospital capital expenditure limit: (2) a national ceiling for the supply of hospital beds; and (3) a national standard for the rate of occupancy of hospital beds.
Sets forth the criteria to be considered by State health planning agencies when considering applications for certificates of need submitted by health facilities.
Prohibits Federal payments under the Medicaid, Medicare, and Maternal and Child Health Services programs of the Social Security Act, to any State that has not entered into an agreement with the Secretary pursuant to the provisions of this Act.
Prohibits any person engaged in the business of selling medical equipment in interstate commerce from making any sale for more than $150,000 unless the designated State health agency determines that there is a need for the use of such equipment by the purchaser.
Title III: Program to assist and Encourage the Discontinuance of Unneeded Hospital Services - Directs the Secretary to establish a program of financial incentives for the discontinuance of unneeded hospital services during the 54 month period beginning on the effective date of this Act.
Allows a hospital which has been in operation for at least two years and which intends to: (1) discontinue providing inpatient health services; or (2) discontinue an identification unit of the hospital; or (3) which intends to convert an identifiable part of the hospital into a long-term care facility or an ambulatory care facility to apply for an incentive payment under this title.
Sets forth the formula to be used in determining the amount of incentive payments.
Introduced in House
Introduced in House
Referred to House Committee on Interstate and Foreign Commerce.
Referred to House Committee on Ways and Means.
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