Relates to reimbursement rates for inpatient hospital services at Westchester medical center

3 Co-sponsors

• Suzi Oppenheimer
• Jeffrey D. Klein
• Ruth Hassell-Thompson

Title of bill

An act to amend the public health law, in relation to reimbursement rates for inpatient hospital services at Westchester medical center

Purpose or general idea of bill

To provide revenue to Westchester County Health Care Corporation through the adjustment of its Medicaid rate.

Summary of specific provisions

Section 1 of the bill provides technical changes to the public health law regarding the computation of reimbursement rates for Westchester Medical Center.

Section 2 is the effective date.

Justification

The Westchester County Health Care Corporation was created under the public authorities law, and in January of 1998, assumed responsibility for the operation of Westchester Medical Center (WMC), a general hospital licensed under Article 28 of the public health law, which previously had been operated by Westchester County. WMC operates 635 licensed inpatient beds, and was established to serve as the regional referral center providing tertiary services to the seven-county Hudson Valley region.

WMC operates the only Level 1 trauma center, Level IV Neonatal ICU, Children's Hospital, transplant center and burn unit in the region and is the only academic medical center between New York City and Albany. In its report, the Commission on Healthcare Facilities in the 21st Century recognized WMC as a critically needed safety net hospital. During its over ten years of existence as a free standing hospital operated by a public benefit corporation, WMC has not been adequately reimbursed, but has continued to provide care to Medicaid and other indigent patients.

The lack of adequate reimbursement resulted from the decision to place WMC in the Academic Medical Center Peer group for hospital reimbursement rather than the Major Public Hospital peer group. The resulting shortfall has resulted in significant financial strains at WMC, and was recognized by the Legislature when it passed special legislation in 2006 that provided $25 million per year for three years in added Medicaid reimbursement to WMC. It was expected that during that three year period of time, a permanent solution to the shortfall would be identified, however this did not happen. This legislation provides for calculation of WMCs Medicaid rate based on the group average of the Major Public Hospital peer group.

The bill does not change the calculation of the group average for any peer group. It simply seeks to provide WMC with an appropriate level of reimbursement, taking into consideration the fact that WMC has been reimbursed inadequately for its entire existence as a public benefit corporation.

Legislative history

2009 - New Bill

Fiscal implications

The Medicaid rate adjustment will direct approximately $11 million to the Westchester County Health Care Corporation's Westchester Medical Center annually.

Effective date

This act shall take effect immediately.