Ruling on Medicare/Medicaid reimbursements could bring $1B to upstate hospitals

WASHINGTON, D.C. | Following years of advocacy, U.S. Senate Majority Leader Charles E. Schumer revealed that the recently announced Centers for Medicare and Medicaid Services (CMS) proposed rules change could have an estimated nearly $1 billion impact annually for increased payments to Upstate New York hospitals. Locally, Adirondack Medical Center could expect an additional revenue of nearly $5 million annually while Champlain Valley Physicians Hospital could see more than $10 million. "For far too long, Upstate New York hospitals have faced unfairly low Medicare payments that fell terribly short of wage demands leaving hospitals struggling to compete to bring the best doctors and nurses to Upstate New York. After years of fighting, though, the feds have finally shifted course, and proposed a new rule that can help finally rectify the unfair payment system and give Upstate N.Y. the shot in the arm it has long needed to the tune of nearly a billion dollars every single year," said Schumer May 5. "This means that hospitals from Buffalo to Albany and Watertown to Binghamton, big and small, in rural and urban areas, can get the support they have long deserved. I will use all my clout as majority leader to push CMS to finalize this proposed wage increase, and I won't stop until Upstate NY hospitals get the full reimbursements they have been denied for too long." Schumer explained that CMS's FY2024 Hospital Inpatient PPS Proposed Rule would amend the Medicare formula to include $967+ million in increased federal funding for hospital systems across Upstate New York, which for years have received less than the national average for the services they provide. Schumer explained that the Medicare Wage Index rate is used to determine how much money the U.S. Government pays hospitals for labor costs when they treat Medicare patients. Each metro area is assigned a rate that dictates whether they receive more or less than the national average for health care labor costs. For example, since the 1980s, hospitals in the Albany area have received only 86 percent of what the average hospital receives to account for wages, which is not reflective of the true wages and labor market in Albany. The FY24 Inpatient Prospective Payment System (IPPS) proposed rule would increase the Capital Region's adjustment to 122 percent of what the average hospital receives in wage adjustments, finally acknowledging that the region needs much higher than averages wages to compete and bring in the best providers, thereby bringing hundreds of millions in federal funding to Capital Region hospitals each year. This is true across the regions in Upstate New York. Upstate New York region, showing estimated increase in Medicare Wage Index payments for hospitals with proposed rule change Southern Tier: $111,294,513 Western New York: $170,097,923 Rochester-Finger Lakes: $242,572,031 Central New York: $121,408,292 Capital Region: $192,838,921 North Country: $41,720,328 Mohawk Valley: $87,249,088 Schumer is now launching an all-out push to ensure that the proposal is finalized by CMS. Schumer said he will work with fellow representatives, New York hospitals and other stakeholders to support the proposal, which will go through a period of review, public input, and final approval. North Country region, showing estimated increase in Medicare Wage Index payments for hospitals with proposed rule change North Country: $41,720,328 Samaritan Medical Center: $7,474,517 University of Vermont Health Network - Champlain Valley Physicians Hospital: $10,834,966 University of Vermont Health Network - Alice Hyde Medical Center: $4,272,596 Massena Hospital: $1,522,056 Claxton-Hepburn Medical Center: $7,165,654 Canton-Potsdam Hospital: $5,538,938 Adirondack Medical Center: $4,911,601

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Ruling on Medicare/Medicaid reimbursements could bring $1B to upstate hospitals

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