Deborah application for higher Medicare reimbursement approved after Menendez language included in February budget bill
NEWARK, N.J – U.S. Senator Bob Menendez and Deborah Heart and Lung Center today celebrated the approval of the hospital’s application to be considered a Medicare Dependent Hospital, making it eligible for approximately $4.5 – 5 million a year in additional Medicare funding as a result of the higher reimbursement rate.
Sen. Menendez has spent recent years fighting to pass legislation,including introducing the Fairness for our Hospitals Act in 2016, to allow rural hospitals in “all-urban states” to be eligible for the same Medicare reimbursement rate rural hospitals in other states receive. In February, the senator successfully advocated for modifications to the Medicare Dependent Hospital program (MDH) to be included in the Bipartisan Budget Act of 2018 providing long overdue equity to Deborah Heart and Lung.
“We are so grateful to Senator Bob Menendez for everything he did to make this great day possible.” said Joseph Chirichella, President and CEO of Deborah Heart and Lung Center. “Our shared constituency of patients and employees is fortunate to have him fighting for us every day in Washington DC. Thanks to his bipartisan leadership, Deborah will now have the resources to continue its founding mission of caring for all of those in need, regardless of their ability to pay. What a wonderful outcome for New Jersey!”
“I’ve fought tirelessly to ensure that Deborah is on equal footing with other rural hospitals across the nation when it comes to critical Medicare reimbursement dollars,” said Sen. Menendez. “This was a tough fight, and I am glad to see that the discrimination against hospitals in New Jersey and other ‘all urban states’ willfinally end. Deborah’s mission of providing the best cardiac, pulmonary and vascular care—while never once billing a patient—is the model of what a hospital should be, and this provision will ensure New Jersey seniors continue to have access to top notch care.”
The modifications to the MDH in the Bipartisan Budget Act of 2018 closes an unfair loophole in federal law that prevents rural hospitals in states designated all-urban by the Centers for Medicare and Medicaid Services (CMS), like New Jersey, from benefitting from MDH payments and receiving fair Medicare reimbursement levels.
New Jersey is one of only three “all-urban” states—along with Delaware and Rhode Island—based on population density, instead of geography. As a result, local hospitals that would otherwise qualify, like Deborah, were denied additional Medicare reimbursements, contrary to the intent and goals of the Medicare program.
Deborah is a not-for-profit specialty hospital dedicated to cardiac and pulmonary care located in the heart of New Jersey’s Pine Barrens. It accepts Medicare and other insurance, but has traditionally provided its patients with high-quality care at zero out-of-pocket expense.
As a senior member of the Senate Finance Committee with sole jurisdiction over Medicare, Sen. Menendez has repeatedly pushed HHS and CMS to provide equitable Medicare reimbursement rates for New Jersey’s rural hospitals. He twice introduced a bill aimed at more broadly providing for urban hospitals, called the Urban Medicare-Dependent Care Act, in the 111th and 112th Congresses, and introduced the measure as an amendment to the Affordable Care Act (ACA).