Medicare Booting Elderly From Hospitals, Heinz Says

Thousands of elderly sick people have been discharged prematurely or transferred inappropriately from hospitals because of a cost-saving Medicare regulation, Sen. John Heinz (R-Pa.) charged today.

“The cases I have reviewed are blatant examples of calculated gambling by hospitals and doctors where the stakes are the lives of thousands of sick, older Americans,” Heinz said.

He has asked the Department of Health and Human Services to cooperate with the Senate Special Committee on Aging, which he chairs, in an investigation.

At issue is a 2-year-old Medicare regulation under which hospitals are reimbursed for care on a predetermined, specific rate for a diagnosis, instead of billing after the treatment.

To prevent hospitals from discharging patients early in order to save money, the Medicare system hires peer review organizations.

Heinz said Congress empowered those organizations to penalize hospitals or withhold payment if it was found that administrators or doctors had shipped out patients too early.

Yet, the senator said, the Health Care Financing Administration, which administers Medicare, has failed to spell out to the peer review organizations that they can take “corrective action.”

As a result, Heinz said there is no evidence that hospitals have been disciplined for kicking patients out of their beds before they are well.

“We need immediate instructions . . . to crack down on those hospitals prematurely discharging patients,” he said.

Heinz said the peer review organizations have uncovered 3,700 instances as of last March in which patients were handled improperly. Although he had no exact figures, Heinz said it appeared some patients had died.