Wednesday, Sept. 23, 2009 | 2 a.m.
In Today's Sun
- Harry Reid cuts Medicaid deal for Nevada (9-22-2009)
- Ensign will offer 30 tweaks to health care bill (9-22-2009)
- How the overhaul could alter the popular but costly Medicare Advantage (9-20-2009)
- Sticker shock: How the overhaul could exact a heavy toll on state finances (9-20-2009)
- Desperate for insurance, residents share health care woes (9-18-2009)
- Nationwide tour promoting health care reform ends in Las Vegas (9-18-2009)
- Harry Reid: Health care bill won't work for Nevada (9-16-2009)
- Grant to aid 400 waiting for Medicare (9-14-2009)
- Editorial: Lowering Medicare costs (9-2-2009)
- Medicare Advantage plans may lose federal cash (1-16-2009)
Beyond the Sun
A tough-to-decipher clause in an amendment to the Senate Finance Committee health care bill would give a long-sought financial assist to the Nevada Cancer Institute.
The amendment would change the way the cancer center is reimbursed by Medicare, allowing the Nevada institution to join others across the nation that are exempt from the standard payment system.
But you wouldn’t know that by reading the amendment.
The amendment, as first reported by The New York Times, says the change would be allowed for an institution that “was designated on June 10, 2003 as the official cancer institute of its State.”
Hmm. Which institution could that be? The Nevada Cancer Institute earned its designation on that date.
The Times reported that Nevada is one of four institutions that stand to benefit from the amendment (the others would benefit from similarly clever wording).
Such targeted measures are known affectionately as “rifle shots.”
The amendment was offered jointly by Sen. Debbie Stabenow, D-Mich., and Sen. Robert Menendez, D-N.J., who both have institutions in their home states that would benefit.
So how did the Nevada Cancer Institute get included?
Senate Majority Leader Harry Reid had sought the exemption for the Nevada Cancer Institute in a bill last year, his staff said. Reid’s office said his Senate colleagues approached him to include Nevada in their amendment to the committee health care bill this week.
Nevada Cancer Institute officials said they are pleased, noting the change would stop the loss of millions of dollars a year for services that are not fully reimbursed.
The institute argues that standard Medicare reimbursement rates for hospitals are not appropriate for specialty institutes that employ more research-based treatments, which are not be eligible for Medicare reimbursement.
Many hospitals and facilities have won exemptions since Medicare adopted a standard hospital payment system in the 1980s. By 1996, according to one study by the Medicare Payment Advisory Commission, a congressional agency that advises Congress on Medicare issues, 3,500 institutions nationwide had received such exemptions, including 10 cancer centers and more than 70 children’s hospitals. Most of the exemptions went to rehabilitation and psychiatric facilities.
Cancer centers that did not initially qualify for an exemption can do so now only legislatively.
Jennifer McDonnell, spokeswoman for the Nevada Cancer Institute, said Nevada should be able to receive the same reimbursement that other cancer institutes receive. The center has sought the exemption since 2008.
“We appreciate Sen. Reid’s assistance in helping Nevada Cancer Institute expand so we can offer Nevadans a whole range of cancer services,” she said.