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, 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. Defines terms used in this Act.
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 twelve 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 with the decision of the Secretary to grant or not to 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 these prohibitions to: (1) a Federal excise tax established by this Act; (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 the cost containment provisions: (1) hospitals meeting specified criteria, provided the Governor of the State in which such hospital is located requests such exclusion; and (2) hospitals engaged in certain experiments or demonstrations authorized by the Social Security Act.
Requires every hospital to submit semiannually to the appropriate health systems agency its average semiprivate room rate and the charges for the ten other representative services most important for purposes of comparing hospitals.
Amends the Internal Revenue Code of 1959 to impose an excise tax on payments received for inpatient hospital services in excess of the inpatient hospital revenue increase limit.
Title II: Limitation on Hospital Capital Expenditures - Amends the Public Health Service Act to require the Secretary to promulgate: (1) an annual hospital capital expenditures limit; (2) a national ceiling for the supply of hospital beds; and (3) a national standard for the rate if occupancy of hospital beds.
Sets forth the criteria to be considered by State health planning agencies when considering applications for certificates of needs submitted by health facilities. States that the aggregate of capital expenditures in a State under certificates of need may not exceed the hospital capital expenditures limit for the State for the year as established by the Secretary.
Reported to House from the Committee on Interstate and Foreign Commerce with amendment, H. Rept. 95-1789 (Part I).
Introduced in Senate
Referred to Senate Committee on Finance.
Referred to Senate Committee on Human Resources.
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