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U.S. Rep. Grothman Hears About Market Instability, 340B, HOPD and Medicare Extenders

August 11, 2017

Close to a dozen hospital and health system leaders met with U.S. Rep. Glenn Grothman for a roundtable discussion on health care issues. Aurora Sheboygan Memorial Medical Center hosted the meeting. 

Attendees discussed recent U.S. Senate inaction on the Affordable Care Act (ACA) and how that continues to impact communities, hospitals and patients in Grothman’s district. The group urged Grothman to support market stability through funding of the ACA’s Cost Sharing Reductions. 

Further, the group spent considerable time briefing Grothman on the importance of the 340B drug discount program to many rural and urban safety-net hospitals, including in his district. The 340B program allows qualifying safety-net hospitals to address the increasing cost of pharmaceuticals while putting those savings directly to use in local communities. Participants provided multiple real-life examples of how their hospitals were using 340B savings throughout Rep. Grothman’s district and providing much-needed access to services and pharmaceuticals, including for behavioral health care. 

Another component of the 340B discussion was how a poorly crafted 2015 law on certain hospital outpatient departments (HOPDs) was negatively impacting the payment for these very behavioral health services. The statutory provision is Section 603 of the 2015 Bipartisan Budget Act. Under this provision, a subset of HOPDs were excluded from using the very Medicare reimbursement schedule under which they were designed to be reimbursed. In its place, these impacted HOPDs now receive only half of their previous reimbursements and potentially face an additional 50 percent reduction in those payments. Attendees urged Grothman to support a fix for these impacted HOPDs. 

In closing, the group reminded Rep. Grothman that Congress still has important issues to address in the fall, including funding the Children’s Health Insurance Program (CHIP) and Medicare Dependent Hospitals (MDH) and Low Volume Adjustment hospital payments. 

Individuals participating in this meeting included: David Graebner, Aurora Sheboygan Memorial Medical Center; Andy Bagnall, HSHS St. Nicholas Hospital; William Hart, Columbia St. Mary’s; Mary Maurer, Holy Family Memorial; Mike Binder, Mercy Medical Center; Reggie Newson and Elizabeth Cliffe, Ascension Wisconsin; Tony Curry, Aurora Health Care; and Jenny Boese, Wisconsin Hospital Association.

 

This story originally appeared in the August 11, 2017 edition of WHA Newsletter