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Congresswoman Clarke’s Statement on Concerns About the “Doc Fix”

Brooklyn, N.Y. – Congresswoman Yvette D. Clarke released the following statement about her concerns that the Republican Medicare bill, a twelve-month extension for payments to physicians also known as the “doc fix,” could reduce support for safety-net hospitals in Brooklyn.

By a voice vote, the House of Representatives passed H.R. 4302, the “Protecting Access to Medicare Act of 2014,”which prevents a nearly twenty-four percent reduction in Medicare payments to physicians scheduled to occur on April 1, 2014 and extends the 0.5 percent increase for medical service providers for the remainder of 2014.

“There were parts of this bill that I agreed with, such as the technical corrections to the long-term care hospital (LTCH) criteria which Brooklyn hospitals needed,” said Congresswoman Clarke. Previously, in order to qualify as a long-term care hospital, overall  Medicare discharges had to not only meet certain pre-discharge qualifications, but also be 50 % of the overall number of  hospital discharges.  While still requiring that 50% of the Medicare discharges meet certain pre-discharge qualifications, the technical correction would require those discharges be compared to the overall number of Medicare discharges and not the overall number of hospital discharges. 

“I am concerned, however, that the extension of the ‘two-midnight rule,’ and the suspension of audits for those short-stay inpatient claims could have adverse impacts on hospitals. The delay in implementing changes to the ‘two-midnight rule’ and in initiating audits of such claims has cost taxpayers billions of dollars.”   Under the two-midnight rule, in order for patients to receive “inpatient status,” they must spend at least “two-midnights” in the hospital, otherwise they are considered “outpatients”.  Inpatient costs are higher than outpatient costs. This arbitrary rule has forced doctors to make admitting decisions, not necessarily based on the needs of their patients, but rather on the rule.  Additionally, because inpatient costs are higher than outpatient costs, the cost to taxpayers has increased.  I am also concerned that reductions in payments to medical service providers will only remove needed funds from our hospitals and other medical facilities. This makes no sense. ”

Congresswoman Clarke continued, “I hope that we will ultimately resolve the deficiencies in the ‘doc fix.’ Patients need to have access to quality, affordable healthcare – which means that they need access to highly skilled and qualified doctors.”

U.S. Representative Yvette D. Clarke is a member of the House Committee on Small Business, Ethics, and Homeland Security, where she is the Ranking Member of the Subcommittee on Cybersecurity, Infrastructure Protection, and Security Technologies. She represents many neighborhoods in central and southern Brooklyn, NY which include Brownsville, Crown Heights, East Flatbush, Flatbush, Gerritsen Beach, Madison, Midwood, parts of Park Slope and Flatlands, Prospect Heights, Prospect-Lefferts Gardens, Sheepshead Bay, and Windsor Terrace.