On Tuesday, Congressmen Joe Crowley (East Bronx, Queens) announced the Centers for Medicare and Medicaid Services (CMS) agreed to correct the payment method for Calvary Hospital ensuring the hospital will be fairly reimbursed for the services it provides.
“This payment change will make a world of difference to not just Calvary Hospital and its financial stability, but also to the New Yorkers and their families who rely on this critical resource. I’ve been proud to work with Congressman Rangel on this issue, and we appreciate the support of our New York colleagues in helping us convince CMS that this change was needed,” said Rep. Crowley.
Calvary Hospital is located off of Eastchester Road near the future Morris Park Metro North stop across from the Jack D. Weiler hospital of Montefiore/Albert Einstein College of Medecine. The hopital predominantly serves end-stage cancer patients who require more serious care than at-home hospice or skilled nursing facilities can provide, and has been inappropriately grouped by Medicare with long-term care hospitals that aim to instead treat and then discharge patients.
This has been an issue for 15 years. As a result, the hospital was effectively financially penalized for providing longer-term care to more severe cases. Recent changes to payment policies for long-term care hospitals further threatened Calvary’s financial stability, making the need for this change more urgent. Reverting Calvary Hospital back to a cost-based reimbursement model is expected to result in an additional $6 million in Medicare payments to the hospital.
“We knew we needed to make sure that Calvary Hospital remained able to serve New Yorkers with their excellent combination of comfort and quality care for severely ill family members, and CMS’s final announcement provides much-needed relief and certainty,” added Crowley. “This is a long-awaited victory, and I’m proud that Congressman Rangel and I were able to finally put this win on the board for Calvary Hospital.”
Rep. Crowley has been engaged on the issue for many years, working with 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 Congressman Charlie 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. This week, CMS finalized this payment rule, after receiving feedback from the congressional delegation, and will put this change into effect moving forward.
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