PRINTER'S NO. 4094
No. 615 Session of 2002
INTRODUCED BY CURRY, CALTAGIRONE, BELFANTI, HANNA, LAUGHLIN,
RUBLEY, SCHRODER, SHANER, T. STEVENSON, TIGUE, WANSACZ,
WATSON, G. WRIGHT, ROEBUCK, MICHLOVIC, BARD, BARRAR, BEBKO-
JONES, BISHOP, BROWNE, BUNT, CAWLEY, M. COHEN, CREIGHTON,
DeLUCA, DERMODY, BROOKS, D. EVANS, FEESE, FRANKEL, FREEMAN,
GEORGE, GORDNER, HENNESSEY, HERSHEY, HESS, HORSEY, JAMES,
JOSEPHS, MANDERINO, MELIO, MUNDY, PISTELLA, SATHER,
SCRIMENTI, SOLOBAY, THOMAS, TRICH, WASHINGTON, J. WILLIAMS,
YOUNGBLOOD AND PALLONE, JUNE 25, 2002
REFERRED TO COMMITTEE ON RULES, JUNE 25, 2002
A RESOLUTION
1 Directing the Legislative Budget and Finance Committee to
2 conduct an economic/actuarial study of health insurers in
3 this Commonwealth in order to evaluate the adequacy of
4 reimbursement rates for physicians and hospitals.
5 WHEREAS, According to the Annual Statistical Report of the
6 Insurance Department of the Commonwealth of Pennsylvania for the
7 period July 1, 2000, to June 30, 2001, Pennsylvania residents in
8 the fiscal year spent over $19 billion on health insurance; and
9 WHEREAS, Insurers have raised premiums and increased profits
10 even in periods of economic downturn; and
11 WHEREAS, Physician reimbursement rates from insurers have
12 decreased in real dollars over the past decade; and
13 WHEREAS, Many insurers have attempted to lower costs through
14 either capitation or arbitrary reduction of fee for service in
15 which the reimbursement to physicians has been continually
1 decreased; and
2 WHEREAS, An environment in which reimbursement levels are
3 extremely low threatens physicians' ability to deliver services;
4 and
5 WHEREAS, Hospital reimbursement rates have also decreased in
6 real dollars over the past decade; and
7 WHEREAS, Sixty-two hospitals in Pennsylvania were unable to
8 cover operating expenses with patient revenues in the fiscal
9 year 2001; therefore be it
10 RESOLVED, That the House of Representatives direct the
11 Legislative Budget and Finance Committee to conduct an
12 economic/actuarial study of all health insurers in this
13 Commonwealth in order to evaluate and ascertain the adequacy of
14 reimbursement rates for physicians and hospitals; and be it
15 further
16 RESOLVED, That the Legislative Budget and Finance Committee
17 report shall include, but not be limited to, evaluation of the
18 adequacy of hospital and physician payment rates through:
19 (1) Payment-to-cost comparisons of services provided by
20 physicians and hospitals.
21 (2) Comparison of hospital and physician reimbursement
22 rates of the health insurers in this Commonwealth to medical
23 assistance reimbursement rates.
24 (3) Comparison of hospital and physician reimbursement
25 rates of the health insurers in this Commonwealth to those
26 reimbursement rates in other states.
27 (4) The historical trend of hospital and physician
28 reimbursement rates in real dollars over the past two
29 decades.
30 (5) The influence of competition or a lack of
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1 competition among insurers on hospital reimbursement rates;
2 and be it further
3 RESOLVED, That the Legislative Budget and Finance Committee
4 report its findings to the House of Representatives no later
5 than October 31, 2002.
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