House of Representatives Passes Crowley, Rangel Language Protecting Calvary Hospital from Harmful Medicare Payment Structure

Sep 21, 2016 Issues: Health Care, In the Community

(Washington, D.C.) – Today, Rep. Joe Crowley (D-NY), Vice Chair of the Democratic Caucus, and Rep. Charles B. Rangel announced their language to reclassify Calvary Hospital in the Bronx to reflect the unique services it provides, has passed the House of Representatives as part of H.R. 5713. For 17 years, Calvary Hospital, which predominantly serves end-stage cancer patients who require more serious care than at-home hospice or skilled nursing facilities can provide, had been inappropriately grouped under Medicare law with long-term care hospitals that aim to instead treat and then discharge patients. As a result, the hospital was effectively financially penalized for providing longer-term care to more severe cases. In 2013, Crowley and Rangel led the charge to enact legislation that directed Centers for Medicare and Medicaid Services (CMS) to revert Calvary Hospital back to a cost-based reimbursement model, helping to bring greater financial stability to the hospital. While the change affecting the payment system has begun being implemented, Calvary Hospital is still technically classified as a long-term hospital, creating unnecessary red tape that affects not only Calvary Hospital, but its patients. 

“This is about more than a technical change, this is about bringing certainty to Calvary Hospital and the patients who depend on it each and every day,” said Rep. Crowley. “I’m proud to have worked with Congressman Rangel on an effort that will ensure Calvary Hospital can continue to meet the needs of critically ill patients.”

“Congressman Crowley and I worked hard to ensure that Calvary Hospital can continue to operate programs and outpatient clinics that serve about 30% of terminal cancer patients in New York City. Correct classification will help fulfill its mission to care for the most vulnerable New Yorkers,” said Rep. Rangel.

Reps. Crowley and Rangel have been engaged on this issue for many years, working together on the House Ways and Means Committee to address this issue with CMS and leading several congressional delegation letters to stress Calvary’s unique situation. Their recent efforts directly led to CMS’s policy change. In December 2013, the members introduced legislation to change Calvary’s reimbursement model from long-term care back to their previous model of cost-based reimbursement. In the Bipartisan Budget Act of 2013 (P.L.113-67), Crowley and Rangel secured language authorizing CMS to separate out hospitals like Calvary from other long-term care hospitals and move them to a new payment model. Following this language, Crowley and Rangel spearheaded a letter to CMS from nearly the entire downstate New York delegation urging CMS to make this change without delay. In their proposed hospital payment rule for 2015, CMS announced that they would heed the calls of Crowley, Rangel, and the New York delegation and change Calvary’s payments. However, a change in the underlying statute is needed to codify this policy permanently and avoid future unintended consequences. ‎