A bill to encourage the States to establish cost and quality standards, and to provide incentives to contain inflationary rises in hospital costs.
State Cost Control Plan for Hospitals Act - Title I: State Hospital Cost Control Plan - Declares that each State desiring to conduct a hospital cost containment plan shall submit such a plan to the Secretary of Health, Education, and Welfare for approval. Directs the Secretary to approve a State plan which meets criteria set forth in this Act including: (1) the establishment of a hospital review commission with the authority to supervise the administration of the plan; and (2) the establishment of an advisory council with the duty of reviewing and commenting on the operation of the hospital review commission and acting on appeals of commission decisions.
Directs the Secretary to pay to any State which has a qualified hospital cost control plan which went into effect after July 1, 1977, an amount equal to 100 percent of the reasonable amounts expended by the State for the administration of the State's hospital review commission and its advisory council.
Requires each State hospital review commission to file annually with the Secretary a report on the level of rates of institutional reimbursement approved under the State plan.
Title II: Coordination with Health Planning and Peer Review Activities - Directs each State hospital review commission to review the expenditures of a health care institution for financing costs and depreciation relating to prior capital expenditures. Requires such a commission to disapprove any such expenditures made for services, equipment, and facilities which required but were denied a certificate-of-need pursuant to the Public Health Service Act and the Social Security Act.
Amends Title XI (General Provisions and Professional Standards Review) of the Social Security Act to direct that the expenses of Professional Standards Review Organizations be passed on to the providers whose services are reviewed.
Title III: Federal Hospital Cost Containment Program - Directs that the average reimbursement paid to a hospital for inpatient services under Titles V (Maternal and Child Health and Crippled Children's Services), XVIII (Medicare), and XIX (Medicaid) of the Social Security Act, and the average charges imposed by a hospital for inpatient services may not exceed the base inpatient hospital revenue per inpatient admission as established pursuant to this Act, by a specified percentage. Sets forth formulas by which determinations of inpatient care costs shall be calculated for the purposes of this Act.
Sets forth conditions under which the Secretary may grant exceptions from the limits established under this Act. Subjects any hospital granted an exception from the cost limits imposed by this Act to an operational review by the Secretary. Grants any hospital which is adversely affected by a determination of the Secretary in connection with the application or granting of an exception the right to a hearing before the Provider Reimbursement Review Board established under the Medicare program if the amount in controversy is $25,000 or more. Directs the Secretary to appoint five additional members to such Board for the purpose of reviewing appeals under this Title.
Subjects hospitals or cost payers which receive reimbursement in excess of levels permitted under this Title 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 and Crippled Children's Services programs of the Social Security Act.
Amends the Internal Revenue Code of 1954 to impose an excise tax on payments received for inpatient hospital services in excess of the limits established by this Act.
Directs the Secretary, for the purpose of obtaining information on costs which can be used in planning and measuring the efficiency of various types of health services facilities and organizations, to establish for each such type of organization, a uniform system for the reporting of information.
Title IV: Limitation on Hospital Capital Expenditures - Amends Title XI (General Provisions and Professional Standards Review) of the Social Security Act to assure that Federal funds appropriated under Titles V, XVIII, and XIX of such Act are not used to support capital expenditures for inpatient hospital services, and are used only to support expenditures for other health services which are determined to be necessary through the health service and facilities planning activities in the various States.
Title V: Revisions of Title XV of the Public Health Service Act - Amends the Public Health Service Act to define as surplus any institutional health service found to be unneeded according to the standards applied in determining whether a proposed new service shall be granted a certificate of need. Declares that any such service declared surplus shall be considered as though it had been denied a certificate-of-need. Directs the Secretary to make grants to institutions which have discontinued health services pursuant to a determination that such services were surplus. Limits the amount of such grant to the amount of debt incurred by the institution in developing the service declared surplus which remains outstanding.
Referred to House Committee on Ways and Means.
Introduced in Senate
Referred to Senate Committee on Finance.
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