Ufisinan Todu Guam S E NAT 0 R D E N N I S G. R 0 D RI G U E Z, Jr.

Transcription

1 Ufisinan Todu Guam S E NAT 0 R D E N N I S G. R 0 D RI G U E Z, Jr. I Mina'trentai Unu Na Liheslaturan Guahan CHAIRMAN, COMMITTEE ON HEALTH & HUMAN SERVICES, ECONOMIC DEVELOPMENT, SENIOR CITIZENS AND ELECTION REFORM June 04, 2012 Honorable Judith T. Won Pat, Ed.D. Speaker I Mina'Trentai Unu Na Liheslaturan Guahan 155 Hesler Place Hagatfia, Guam 9691 O,_,,T... VIA: The Honorable Rory J. Respicio A.~ Chairperson, R)lfeS' RE: Sponsor Report-Resolution No l(COR) Dear Speaker Won Pat: Transmitted herewith, for your consideration, is the Sponsor Report on Resolution NO (COR); Relative to requesting the United States Department of Health and Human Services Secretary Kathleen Sebelius to prioritize and approve the Guam Memorial Hospital Authority's request for relief of Medicare reimbursement rates under the Tax Equity and Fiscal Responsibility Act of 1982 and to express the dire and emergent situation the only civilian hospital on Guam faces due to the large disparity in collecting reimbursements from Medicare;" Sponsored by Dennis G. Rodriguez, Jr., and referred to the Health & Human Services, Economic Development, Senior Citizens and Election Reform. Resolution No (COR) was publicly heard on June 1, Votes are as follows: Senseramente, -- TO PASS --NOTTO PASS -- ABSTAIN ---''-- TO REPORT OUT ONLY -- TO PLACE IN INACTIVE FILE Senat~ Rodriguez, Jr. Chairman Attachments / 176 Serenu Avenue Suite 107 Tamuning, Guam Telephone: senatordrodriguez@gmail.com

2 Ufisinan Todu Guam S E NAT 0 R D E N N I S G. R 0 D RI G U E Z, Jr. I Mina'trentai Unu Na Liheslaturan Guahan CHAIRMAN, COMMITTEE ON HEALTH & HUMAN SERVICES, ECONOMIC DEVELOPMENT, SENIOR CITIZENS AND ELECTION REFORM SPONSOR REPORT ON Resolution NO (COR) Sponsored By: Senator Dennis G. Rodriguez, Jr. Relative to requesting the United States Department of Health and Human Services Secretary Kathleen Sebelius to prioritize and approve the Guam Memorial Hospital Authority's request for relief of Medicare reimbursement rates under the Tax Equity and Fiscal Responsibility Act of 1982 and to express the dire and emergent situation the only civilian hospital on Guam faces due to the large disparity in collecting reimbursements from Medicare." 176 Serenu Avenue Suite 107 Tamuning, Guam Telephone: senatordrodriguez@gmail.com

3 Ufisinan Todu Guam S E NAT 0 R D E N N I S G. R 0 D RI G U E Z, Jr. I Mina'trentai Unu Na Liheslaturan Guahan CHAIRMAN, COMMITTEE ON HEAL TH & HUMAN SERVICES, ECONOMIC DEVELOPMENT, SENIOR CITIZENS AND ELECTION REFORM June 04, 2012 MEMORANDUM To: ALL SENATORS Health & Human Services, Economic Development, Senior Citizens and Election Reform From: Senator Dennis G. Rodriguez, Jr. / Sponsor J-/ Subject: Sponsor Report on Resolution no l(COR). Transmitted herewith, for your consideration, is the Sponsor Report on Resolution NO (COR); Relative to requesting the United States Department of Health and Human Services Secretary Kathleen Sebelius to prioritize and approve the Guam Memorial Hospital Authority's request for relief of Medicare reimbursement rates under the Tax Equity and Fiscal Responsibility Act of 1982 and to express the dire and emergent situation the only civilian hospital on Guam faces due to the large disparity in collecting reimbursements from Medicare;" Sponsored by Dennis G. Rodriguez, Jr. and referred to the Health & Human Services, Economic Development, Senior Citizens and Election Reform This report includes the following: Sponsor Voting Sheet Sponsor Report Narrative/Digest Copy of Resolution No (COR) Public Hearing Sign-in Sheet Copies of Submitted Testimony and Supporting Documents Copy of COR Referral of Resolution No (COR) Notices of Public Hearing (1st and 2nd) Copy of the Public Hearing Agenda Related News Articles (Public hearing publication of public notice) Please take the appropriate action on the attached voting sheet. Your attention to this matter is greatly appreciated. Should you have any questions or concerns, please do not hesitate to contact me. Si Yu 'os Ma 'ase '! Attachments 176 Serenu Avenue Suite 107 Tamuning, Guam Telephone: senatordrodriguez@gmail.com

4 Ufisinan Todu Guam S E NAT 0 R D E N N I S G. R 0 D RI G U E Z, Jr. I Mina'trentai Unu Na Liheslaturan Guahan CHAIRMAN, COMMITTEE ON HEALTH & HUMAN SERVICES, ECONOMIC DEVELOPMENT, SENIOR CITIZENS AND ELECTION REFORM VOTING SHEET Resolution NO (COR); Relative to requesting the United States Department of Health and Human Services Secretary Kathleen Sebelius to prioritize and approve the Guam Memorial Hospital Authority's request for relief of Medicare reimbursement rates under the Tax Equity and Fiscal Responsibility Act of 1982 and to express the dire and emergent situation the only civilian hospital on Guam faces due to the large disparity in collecting reimbursements from Medicare;" Sponsored by Senator Dennis G. Rodriguez, Jr. NOT REPORT PLACE IN SIGNATURE TO TO ABSTAIN OUT INACTIVE, Pass PASS ONLY FILE DENNIS G. RODRIGUEZ, Jr. Chairman «'/ / tf"!ti, ADOLPHO B. PALACIOS, Sr. Vice Chairman W////Y f/1/17 JUDITH T. WON PAT, Ed.D. ' Speaker BENJAMIN J. F. CRUZ <' ~~~ ~ Vice-Speaker ~- 1,r:/1;_ TINA ROSE MuNA BARNES { ( ) I I Legislative Secretary, / /kr:f't..._ '-,/ THOMAS C. ADA VICENTE C. PANGELINAN ~ t/l//1'1. RORY J. RESPICIO ~ JUDITH P. GUTHERTZ,DPA ~ r-u I \ FRANK F. BLAS, Jr. v ( ll/4 ( 2-- V. ANTHONY ADA rq -~- ~~ ~/<+), L I I,- ALINE A. YAMASHITA, Ph.D. (OA11 (nh(~ SAM MABINI, Ph.D.! MANA SILVA TAIJERON / CHRISTOPHER M. DUENAS ~ ~~11~ 176 Serenu Avenue Suite 107 Tamuning, Guam Telephone: senatordrodriguez@gmail.com

5 Ufisinan Todu Guam S E N AT 0 R D E N N I S G. R 0 D RI G U E Z, Jr. I Mina'trentai Unu Na Liheslaturan Gudhan CHAIRMAN, COMMITTEE ON HEAL TH & HUMAN SERVICES, ECONOMIC DEVELOPMENT, SENIOR CITIZENS AND ELECTION REFORM REPORT DIGEST Resolution No (COR) I. OVERVIEW: A public hearing was conducted on June 01, 2012, and convened at 12:00 P.M., in I Liheslatura's Public Hearing Room Among the items on the agenda was the consideration of Resolution NO (COR); Relative to requesting the United States Department of Health and Human Services Secretary Kathleen Sebelius to prioritize and approve the Guam Memorial Hospital Authority's request for relief of Medicare reimbursement rates under the Tax Equity and Fiscal Responsibility Act of 1982 and to express the dire and emergent situation the only civilian hospital on Guam faces due to the large disparity in collecting reimbursements from Medicare;" Sponsored by Senator Dennis G. Rodriguez, Jr. Public Notice Requirements Notices were disseminated via hand-delivery/fax and/or to all senators and all main media broadcasting outlets on May 25, 2012 (5-Day Notice), and again on May 30, 2012 (48-Hour Notice). Senators Present Senator Dennis G. Rodriguez, Jr. Senator Aline Yamashita, Ph.D. Senator Sam Mabini, Ph.D. The public hearing on agenda item Resolution No (COR) was Called-to-Order at 12:00 P.M. II. SUMMARY OF TESTIMONY & DISCUSSION. SENATOR DENNIS G. RODRIGUEZ, JR., convened the Public Hearing on Resolution No (COR) at 12:28pm Senator Rodriguez, Jr., author of Resolution No (COR), explained the intent of the Resolution. Thank you We are having this resolution because it is substantive in nature and asks that GMH revisit the Medcaid structure. This is to help us recoup the money for our only hospital. It is important for us to assist GMH to seek this reimbursement. We hope this resolution elevates this to a higher level. We also asked our Congresswoman to help. Mr. Jun Infante: Thank you Senators. I support the resolution and I am sure the hospital supports the resolution. This request did not happen just recently it has been a long process. We have been working with our resolution. The last attempt was Dr. Lizama with the governor to Region 9. That was a 176 Serenu Avenue Suite 107 Tamuning, Guam Telephone: senatordrodriguez@gmail.com

6 ~--'~:-'---;-- ~~:---::-'----~ ~--~----r- - Ufisinan Todu Guam S E NAT 0 R D E N N I S G. R 0 D RI G U E Z, Jr. I Mina'trentai Unu Na Liheslaturan Guahan CHAIRMAN, COMMITTEE ON HEALTH & HUMAN SERVICES, ECONOMIC DEVELOPMENT, SENIOR CITIZENS AND ELECTION REFORM recommendation for the governor to work with his peers. This resolution is only going to help to put more pressure on them and with the help of the congresswoman that will also help. We are support in of this Senator Rodriguez: The request has officially been made? Is that something you can confirm? Mr. Infante: Yes, the person who can better tell this story is Mr. Moroni. Paul Moroni: Paul Moron~ Program coordinator at GMH. There is a formal process for requesting this relief and we have been in the process for several years and we haven't been getting this relief and so we are getting broader support, working with you and the governor's office to get this relief Senator Rodriguez: what does it mean for the financials? Mr. Infante: Bigger reimbursements. The TEFRA was based in 1982 and needs to be rebased. At the time it was based on services provided to the community. The services in 1982 were much less than now. Mr. Moroni: The other thing that needs to be recognized is how far the hospital wants to go to keep and expanded services. Mr. Infante: We are getting $1000 a day per diem and we want more than $1000 a day per diem for each patient. Senator Rodriguez: It is about $15 million that the hospital is losing do to this antiquated base. What is the status now on the billing and collection RFP? Mr. Infante: It is not going to happen today. It is on hold and they are going to stop this one and do a repeat. When? I don't have the exact date now. Senator Rodriguez: Thanks for the update and unfortunately that's not moving anywhere. We must work on other things simultaneously and bring in relief. That hasn't gone anywhere and it is very concerning for the committee and I would like to state that for the record and for you to bring that back to the hospital. Mr. Infante: It is still in the process. It is a procurement process. As far as I know there has to been a letter from the hospital saying that this isn't going to happen. Senator Rodriguez: I am not questioning that, there is just no sense of urgency and it has been about 4 months. We are saying this is urgent for it to bring us money, but the hospital is not doing that. Thank you, especially Mr. Moroni for your work because this is the closest we've been, so I just want to thank you. There being no testimony, or comments by Senators, Senator Rodriguez declared the Resolution as having been duly heard, and concluded the public hearing on Resolution No (COR). The Committee would continue to accept written testimony for a period of ten (10) subsequent to the public hearing. 176 Serenu Avenue Suite 107 Tamuning, Guam Telephone: senatordrodriguez@gmail.com

7 Ufisinan Todu Guam S E NAT 0 R D E N N I S G. R 0 D RI G U E Z, Jr. I Mina'trentai Unu Na Liheslaturan Guahan CHAIRMAN, COMMITTEE ON HEALTH & HUMAN SERVICES, ECONOMIC DEVELOPMENT, SENIOR CITIZENS AND ELECTION REFORM III. FINDINGS & RECOMMENDATIONS The findings are, that in keeping with the Medicare practices within the fifty states, the people of Guam should, at the very least, have its only civilian hospital equitably compensated by Medicare pursuant to a rebased reimbursement rate realistically reflective of the costs for providing medical treatment at today's costs of doing business, using 2009 through 2011 as the base years (COR), 1s hereby reported out with the recommendation to 176 Serenu Avenue Suite 107 Tamuning, Guam Telephone: senatordrodriguez@gmail.com

8 I MINA 'TRENTAI UNU NA LIHESLATURAN GUAHAN 2012(SECOND) Regular Session Resolution No. Introduced by: Y23/3 / l LO{) Dennis G. Rodriguez, Jr. W Relative to requesting the United States Department of Health and Human Services Secretary Kathleen Sebelius to prioritize and approve the Guam Memorial Hospital Authority's request for relief of Medicare reimbursement rates under the Tax Equity and Fiscal Responsibility Act of 1982 and to express the dire and emergent situation the only civilian hospital on Guam faces due to the large disparity in collecting reimbursements from Medicare. e BE IT RESOLVED BY THE COMMITTEE ON RULES OF I MINA 'TRENTAI UNU NA LIHESLATURAN GUAHAN: WHEREAS, the Guam Memorial Hospital Authority (GMHA) plays an integral role in Guam's health care infrastructure as Guam's only public hospital serving the civilian community with a 158 bed acute care hospital facility located in the western U.S. Pacific Territory of Guam; and WHEREAS, GMHA not only provides hospital services for the 160,000 plus residents of Guam, but also provides health care services for migrants from the Freely Associated States of Micronesia, the Republic of the Marshal Islands, the Republic of Palau, the Commonwealth of the Northern Mariana Islands, the civilian support personnel for two (2) major U.S. military installations on Guam, and is the only hospital available to the one million plus tourists who annually visit Guam; and 1

9 e 14 1s 1 WHEREAS, the island of Guam has been facing various economic and 2 social changes that are resulting in raising concerns in the government's ability to 3 adequately address the health care needs of the island population, as incidence 4 rates of disease and associated morbidities are higher now than ever in Guam's s history; and 6 WHEREAS, the Guam Memorial Hospital has taken certain measures to 7 address the ongoing population shifts and demands imposed relative to the s increasing number of cases of non-communicable diseases that currently plagued 9 the island; and 10 WHEREAS, among these are heart diseases, which led to the establishment 11 of a GMHA heart program for cardiology consults, cardiac-catherizations, and 12 open heart surgeries; while increases in Type II Diabetes and associated 13 morbidities have led to the establishment of an Inpatient Hemodialysis Unit and Interventional Radiology Department; in addition to which other trending levels of non-communicable diseases have called for establishing oncology services to deal 16 with increasing incidence of various cancers, orthopedics to address musculo- 17 skeletal and degenerative arthritis, and a neurosurgical department to address 1s cerebrovascular diseases and conditions; and 19 WHEREAS, with the re-emergence of challenges relative to communicable 20 diseases, drug resistant tuberculosis, an aging population with high rates of 21 immune deficiency has led to challenges with multi-drug resistant organisms and 22 increased risks of Hospital acquired infection; and 23 WHEREAS, Southeast Asia I Western Pacific concerns such as influenza, 24 regional challenges such as Tuberculosis, and incidence rates of sexually 2s transmitted diseases are also on the rise, GMHA has worked to address these 26 ongoing concerns with previously unprecedented infection control initiatives and a 27 continually evolving drug library; and 2

10 WHEREAS, improvements in quality of care and expansion in the scope of services at GMH is one of the most significant contributing factors to the island's expanded health care system and improved health outcomes over this period; and WHEREAS, GMH is financially unable to sustain improvements to the quality of care expansion of services without supplemental funding and a reimbursement rate reflective of the actual cost of services; and WHEREAS, the increase in life expectancy has led to an increase of Medicare beneficiaries, with more than 8% of Guam's residents being currently covered by Medicare; compared with only 5% in 2000, and 3% in 1990; and WHEREAS, in 1982, Congress passed the Tax Equity and Fiscal Responsibility Act (TEFRA) that included changes to Medicare, and subsequently, in 1997, passed legislation to create Prospective Payment for Psychiatric and Rehabilitation Hospitals (Psychs PPS and Rehab PPS), whereby, Medicare allowed for TEFRA providers to request additional reimbursements annually, due to the fact that the TEFRA rate no longer represented a fair reimbursement cap to the facility because the patients and services were no longer similar to the Base Period (1982); and WHEREAS, as a result of TEFRA rate that was based on the base years, the Guam Memorial Hospital has reported a net loss $9.5 million in Fiscal Year 2010; and WHEREAS, the most recent Office of Public Accountability (OPA) report issued on March 23, 2012 highlighted GMHA's financial loss of $28.7 million dollars in Fiscal Year 2011, the highest loss in a decade, and during which $7.89 million is the disparity between the actual costs for treatment and Medicare reimbursements to the hospital; and 3

11 1 WHEREAS, the total disparity on Medicare reimbursement loss for Fiscal 2 Years 2010 and 2011 adds up to a total of $17,413,000, a significant loss that could 3 have benefited various outlets in the Guam Memorial Hospital; and 4 WHEREAS, by 2006, the Medicare reimbursement shortfalls due to the 5 TEFRA rate has continued to cause the GMHA to be reimbursed at less than the 6 cost of treating Medicare patients, with losses having grown from $1,500,000 for to over $9,500,000 for 2010, which further exacerbated the challenges and s changes being faced directly related to socio-economic impacts and improvement 9 of services in the hospital; and 10 WHEREAS, Medicare allows hospitals to request an annual exception to 11 the TEFRA Rate based on the variances in patient demographics, patient acuity, 12 and patients treatments to which GMHA has filed. However, Medicare has asked 13 for additional information to compare the current year to the base year twice, 14 requiring more detailed information; 15 WHEREAS, GMHA has been reimbursed by Medicare at less than its 16 actual cost of treatment for the Medicare patients as a result of the TEFRA rate that 17 was set utilizing as base years; and 18 WHEREAS, GMHA does not have the detailed patient and financial 19 records that Medicare requests due to their computer overhaul that was 20 implemented in , resulting in the loss of the records which are no longer 21 in existence and cannot be reconstructed, and now greatly hinders the justification 22 to Medicare that GMHA is entitled to additional compensation; and 23 WHEREAS, Guam's expanding population, accompanied by the necessary 24 development and enhancement of services at GMHA, has led to an increase in the 25 cost of care, with which Medicare reimbursement rates have not kept pace directly 26 due to the lack of documentation which hinders their ability to acquire proper 27 annual TEFRA Exception payments; and 4

12 WHEREAS, that in order to remedy this disparity, GMHA proposes that the Centers for Medicare and Medicaid Services approve the GMHA (Provider No.: ) relief requests for 2006 through 2011, as submitted to the Department of Health and Human Services on February 21,2012 and allow for the rebasing of GMHA's TEFRA limit to FY 2011; and WHEREAS, in February of 2012, the Guam Memorial Hospital Authority, in conjunction with the Office of the Governor of Guam, the Honorable Madeleine Z. Bordallo, Guam's Delegate to Congress, and the Chairman of the Health & Human Services, Senator Dennis G. Rodriguez, Jr., of the 31st Guam Legislature, began coordinating with the Health & Human Services Office of Intergovernmental and External Affairs to address this disparity; and WHEREAS, in March of 2012, the Federal Regional Council took up the issue of these relief requests at their annual conference in San Francisco, California; and WHEREAS, this initiative has since been brought to the attention of the Centers for Medicare and Medicaid Services, Acute Care Division; and now, be it therefore RESOLVED, I Liheslaturan Guahan requests that the Department of Health and Human Services to prioritize the consideration and subsequently approve the Guam Memorial Hospital Authority's request for relief of Medicare reimbursement rates under the Tax Equity and Fiscal Responsibility Act of 1982, as amended ( Prospective Payment for Psychiatric and Rehabilitation Hospitals), and to express the dire and emergent situation Guam's only civilian hospital faces due to the significant disparity between the costs of treatment and 5

13 the outdated base rate set reimbursements from Medicare; and be it, further RESOLVED, I Liheslaturan Guahan requests that the proposes GMHA relief requests be approved based upon the available comparative analysis between the base year and respective years of the relief request ( ), the rebasing of which can be justified using a dual comparative analysis which would include a comparison of the base year and subsequent costs data through 2011, the earliest full years of data available, which if combined, the two approached provide positive justification for GMHA' s rebasing request; and be it, further RESOLVED, that the Speaker and the Chairperson of the Rules certify, and the Secretary of the Legislature attest to, the adoption hereof, and that copies of the same be thereafter transmitted to Ms. Kathleen Sebelius, Secretary, United States Department of Health and Human Services; to the Honorable Madeleine Z. Bordallo, Guam's Delegate to Congress, and to the Honorable Edward J.B. Calvo, I Maga 'lahen Guahan (Governor of Guam). DULY AND REGULARLY ADOPTED BY THE COMMITTEE ON RULES OF I MINA'TRENTAI UNU NA LIHESLATURAN GUAHAN ON THE DAY OF MAY, JUDITH T. WON PAT, Ed.D Speaker RORY RESPICIO Chairman, Rules TINA ROSE MUNA BARNES Legislative Secretary 6

14 S EN AT 0 R DENN I S G. R 0 DR I GUE Z, Jr., Chairman COMMITTEE ON HEALTH & HUMAN SERVICES, ECONOMIC DEVELOPMENT, SENIOR CITIZENS AND ELECTION REFORM Mina 'trentai Unu Na Liheslaturan Guahan 31st Guam Legislature :..., PUBLIC HEARING DATE I TIME: Friday, April 1, pm AGENDA ITEM: Res. No (COR)- Relative to requesting the United States Department of Health and Human Services Secretary Kathleen Sebelius to prioritize and approve the Guam Memorial Hospital Authority's request for relief of Medicare reimbursement rates under the Tax Equity and Fiscal Responsibility Act of 1982 and to express the dire and emergent situation the only civilian hospital on Guam faces due to the large disparity in collecting reimbursements from Medicare. Introduced by Sen. Dennis G. Rodriguez, Jr. PRINT NAME AGENCY or ORAL WRITTEN IN OPPOSE CONTACT '. 0~~TURE ORGANIZATION TESTIMONY TESTIMONY FAVOR NUMBERS : A«f 1 (,,e:ro IN{;-;,.';~ ~ ~~/~ ~ v 6 {??- }"vxz, foul~ I?,~/-}-.._../ - YI~ 1 l'r"i r{ ~ AfYl/ {/ ;;- - y ' ' RES. NO: (COR) Page ) of /

15 _.. COMMITTEE ON RULES / Afina'trentai Unu n,1 Lihes!titumn G.udhm1 The 31st Guam Legislature 155 Hesler Place, Hagacfla, Guam wu u.._f(lttlllut'gisl,1ture.com roryfi1rgum11@p1;,iilrom Tel: ( 671)472-~~79 ~~~~-~~~~-4.7-~~~-~~ _ Senator Rory J. Respicio CHAIRPERSON ~(AJORITY LEADER Senator Judith P. Guthertz VICE CHAIRPERSON ASST. MAJORJTY LEADER MAJORITY MEMBERS: Speaker Judith T. Won Pat Vice Speaker Benjamin J. F. Cruz Senator Tina Rose Muna Barnes LEGISLATIVE SECRETARY MAJORITY \~'HIP Senator Dennis G. Rodriguez.Jr. ASST. ~hjority \\"HIP Senator Thomas C. Ada Senator Adolpho B. Palacios, Sr. Senator vicente c. pangclinan MINORITY MEMBERS: Senator Aline A. Yamashita ASST. MINORITY LEADER Senator Christopher M. Duenas May 25, 2012 MEMORANDUM To: From: Subject: Pat Santos Clerk of the Legislature Attorney Therese M. Terlaje Legislative Legal Counsel Referral of Res No (COR) As Chairperson of the Rules, I am forwarding my referral of Res No (COR). Please ensure that the subject resolution is referred, in my name, to the respective sponsor, as shown on the attachment. I also request that the same be forwarded to all Senators of I Mina'trentai Unu na Liheslaturan Guiihan. Should you have any questions, please feel free to contact our office at Si Yu'os ma'iise! (1) Attachments

16 I Mina' Trentai Unu Na Uheslaturan Guahan Resolutions Log Sheet!. Resolution No. Sponsor Title Date Intro Date of Presentation Date Vote Date Committee/Of Sheet Issued Referred flee Referred Date Adopted (COR) Dennis G. Rodriguez, Jr. Relative to requesting the United States 05/25/12 Department of Health and Human Services 3:50 p.m. Secretary Kathleen Sebelius to prioritize and approve the Guam Memorial Hospital Authority's request for relief of Medicare reimbursement rates under the Tax Equity and Fiscal Responsibility Act of 1982 and to express the dire and emergent situation the only civilian hospital on Guam faces due to the large disparity in collecting reimbursements from Medicare. 5/25/2012 Sponsor Intro/Ref/History 5/25/20125:52 PM

17 SENATOR DENNIS G. RODRIGUEZ, JR. Chairman, Health & Human Services, Senior Citizens, Economic Development, & Election Reform Public Safety, Law Enforcement, &Judiciary Youth, Cultural Affairs, Procurement, General Government Operations, & Publlc Broadcasting Municipal Affairs, Tourism, Housing & Recreation Rules. Federal, Foreign & Micronesian Affairs, & Human & Natural Resources the Guam Milltary BuUdup & Homeland Security Appropriations, Taxation, Public Debt, Banking. Insurance, Retirement, & Land Utilities, Transportation, Public Works, & Veterans Affairs Assistant Majority Whip May 25,2012 TO: ALL SENA TORS FROM: SENATOR DENNIS G. RODRIGUEZ, JR ~ CHAIRPERSON SUBJECT: 1st NOTICE OF PUBLIC HEARING 1s1 NOTICE OF HEARING Friday, June1, :00PM In accordance with the Open Government Law, Public Law , relative to notice for Public Meetings. Please be advised that the Health & Human Services, Economic Development, Senior Citizens and Election Reform will be conducting a hearing on June 1, 2012, at I Liheslaturan Gutlhan's Public Hearing Room in Hagatna, on the following: 12:00PM Resolution No (COR) Relative to requesting the United States Department of Health and Human Services Secretary Kathleen Sebelius to prioritize and approve the Guam Memorial Hospital Authority's request for relief of Medicare reimbursement rates under the Tax Equity and Fiscal Responsibility Act of 1982 and to express the dire and emergent situation the only civilian hospital on Guam faces due to the large disparity in collecting reimbursements from Medicare. (Introduced by D.G. Rodriguez, Jr.) Testimony should be addressed to Senator Dennis Rodriguez, Jr., Chairman, and may be submitted via- hand delivery to our office at 176 Serenu Avenue Suite 107 Tamuning, Guam or our mailbox at the Main Legislature Building at 155 Hesler Place, Hagatfia, Guam 96910, or via to senatordrodriguez@gmail.com. We comply with Title II of the Americans with Disabilities Act (ADA). Individuals who require an auxiliary aid or service (i.e. qualified sign language interpreters, documents in Braille, large prin~ etc.) for effective communication, or a modification of policies or procedures to participate in a program service, or activity of Senator Dennis Rodriguez, Jr. should contact Clifton Herbert at (TODU) as soon as possible but no later than 48 hours before this scheduled event. We look forward to your attendance and participation. For further information, please contact the Office of Senator Dennis Rodriguez, Jr. at (TODU) Ufisinan Todu Guam 31st Guam Legislature 176 Serenu Avenue, Suite 107, Tamuning, Guam /Telephone: TODU (8638) /Facsimile: senatordrodriguez@gmail.com

18 Joseph Anthony Mesngon 1st Notice of Public Hearing 2 messages Clifton Herbert <cherbert.senatordrodriguez@gmail.com> To: phnotice@guamlegislature.org Fri, May 25, 2012 at 4:59 PM Ufisinan Todu Guam S E N A T 0 R D E N N I S G. R 0 D R I G U E Z, Jr. I Mina'trentai Unu Na Liheslaturan Guahan CHAIRMAN, COMMITTEE ON HEALTH & HUMAN SERVICES, ECONOMIC DEVELOPMENT, SENIOR CITIZENS AND ELECTION REFORM Dear Senators, Buenas yan Hafa Adai! Please see attached 1st notice of public hearing. Should you have any questions or concerns, please feel free to contact this office at any time. Sincerely, Clifton Herbert 176 Serenu Avenue Suite 107 Tamuning, Guam Telephone: Cherbert.senatordrodriguez@gmail.com Website: This may contain data that is confidential, proprietary or non-public personal information, as that term is defined in the Gramm-Leach-Bliley Act (collectively, Confidential Information). The Confidential Information is disclosed conditioned upon your agreement that you will treat it confidentially and in accordance with applicable law, ensure that such data isn't used or disclosed except for the limited purpose for which it's being provided and will notify and cooperate with us regarding any requested or unauthorized disclosure or use of any Confidential Information. By accepting and reviewing the Confidential information, you agree to indemnify us against any losses or expenses, including attorney's fees that we may incur as a result of any unauthorized use or disclosure of this data due to your acts or omissions. If a party other than the intended recipient receives this , he or she is requested to instantly notify us of the erroneous delivery and return to us all data so delivered &view=nt&se::irch=inhnx&th= 1 i 'iii lf')() 1?

19 Listserv: As of May 25, m legisa la tu re. org cor@guamlegislature.org dmanyeros@hotmail.com duenasenator@gmail.com edelynn edleonguerrero@gmail.com edwardglee67l@yahoo.com etajalle@guamlegislature.org faith.r@senatormabini.com floterlaje@gmail.com gavin@tinamunabarnes.com ja jane@tinamunabarnes.com jblas@tinamunabarnes.com jean@tinamunabarnes.com jennifer@senatorpalacios.com jmesngon.senatordrodriguez@gmail.com jtenorio@guamcourts.org leonguerrero.angela@gmail.com louise_atalig@yahoo.com maryfejeran@gmail.com mis@guamlegislature.org mtorres.senatordrodriguez@gmail.com ncruz.senatordrodriguez@gmail.com office@senatorada.org peterlg@gmail.com pris@senatorpalacios.com regine@tinamunabarnes.com rob.tupaz@gmail.com santos.duenas@gmail.com senator@senatorbjcruz.com senator@tinamunabarnes.com senatormabini@senatormabini.com senatorsam@senatormabini.com senbenp@guam.net sgra mlegislature.org sonedera-salas@guamlegislature.org spea tanya4families@gmail.com m. net tinaokada@gmail.com tterlaje@guam.net val.g@senatormabini.com vkomiyama.senatordrodriguez@gmail.com aokada@guamlegislature.org

20 SENATOR DENNIS G. RODRIGUEZ, JR. Chairman, Health & Human Services, Senior Citizens, Economic Development, & Election Reform Public Safety, Law Enforcement, &judiciary Youth, Cultural Affairs, Procurement, General Government Operations, & Public Broadcasting Municipal Affairs, Tourism, Housing & Recreation Rules, Federal, Foreign & Micronesian Affairs, & Human & Natural Resources the Guam Military Buildup & Homeland Security Appropriations, Taxation, Public Debt, Banking, Insurance, Retirement, & Land Utilities, Transportation, Public Works, & Veterans Affairs Assistant Majority Whip PRESS RELEASE FIRST NOTICE OF PUBLIC HEARING Friday, June 1, :00PM In accordance with the Open Government Law, Public Law , relative to notice for Public Meetings. Please be advised that the Health & Human Services, Economic Development, Senior Citizens and Election Reform will be conducting a Public Hearing on Friday, June 1, 2012, 12:00 P.M., at I Liheslaturan Guahan's Public Hearing Room in Hagatfia, on the following: 12:00PM Resolution No (COR) Relative to requesting the United States Department of Health and Human Services Secretary Kathleen Sebelius to prioritize and approve the Guam Memorial Hospital Authority's request for relief of Medicare reimbursement rates under the Tax Equity and Fiscal Responsibility Act of 1982 and to express the dire and emergent situation the only civilian hospital on Guam faces due to the large disparity in collecting reimbursements from Medicare. (Introduced by D.G. Rodriguez, Jr.) Testimony should be addressed to Senator Dennis Rodriguez, Jr., Chairman, and may be submitted via- hand delivery to our office at 176 Serenu Avenue Suite 107 Tamuning, Guam or our mailbox at the Main Legislature Building at 155 Hesler Place, Hagatna, Guam 96910, or via to senatordrodriguez@gmail.com. We comply with Title II of the Americans with Disabilities Act (ADA). Individuals who require an auxiliary aid or service (i.e. qualified sign language interpreters, documents in Braille, large print, etc.) for effective communication, or a modification of policies or procedures to participate in a program service, or activity of Senator Dennis Rodriguez, Jr. should contact our office at (TODU) as soon as possible but no later than 48 hours before this scheduled event. We look forward to your attendance and participation. For further information, please contact the Office of Senator Dennis Rodriguez, Jr. at (TODU) Ufisinan Todu Guam JJst Guam Legislature 176 Serenu Avenue, Suite 107, Tamuning, Guam /Telephone: TODU (8638) /Facsimile: senatordrodriguez@gmail.com

21 ~ Senators 1st Notice Public Hearing June 1, 2012.pdf 66K Fri, May 25, 2012 at 5:05 Clifton Herbert PM To: Amritha Alladi Arvin Temkar "George, Duane M" gerry partido James Janela Jesse Lujan "Jon A. Anderson" Jr Katrina Ken Quintanilla Kevin Kerrigan Kevin Kerrigan Laura Matthews Mindy Aguon Oyaol Ngirairikl Pacific Daily News William Gibson Bee: Hafa Adai all Media! Ufisinan Todu Guam SEN AT 0 R DENN IS G. R 0 DR I GUE Z, Jr. I Mina'trentai Unu Na Liheslaturan Guahan CHAIRMAN, COMMITTEE ON HEALTH & HUMAN SERVICES. ECONOMIC DEVELOPMENT, SENIOR CITIZENS AND ELECTION REFORM Please see attached 1st notice of Public Hearing. Should you have any questions or concerns please feel free to contact this office at anytime. Sincerely, Clifton Herbert [Quoted text hidden] 2 attachments ""'-' Public Hearing 1st Notice June 1, 2012.pdf il:l 386K ~ Public Hearing 1st Notice June 1, 2012.doc 546K httos://mail.!!oo!!le.com/mail/u/0/?11i=2&ik=4qrrl 14ff~iR&viPw=ntRr«P.::irrh=inhrw&th= 1 i

22 SENATOR DENNIS G. RODRIGUEZ, JR. Chairman, Health & Human Services, Senior Citizens, Economic Development, & Election Reform Public Safety, Law Enforcement. &Judiciary Youth, Cultural Affairs, Procurement, General Government Operations, & Public Broadcasting Municipal Affairs, Tourism, Housing & Recreation Rules, Federal, Foreign & Micronesian Affairs, & Human & Natural Resources the Guam Military Buildup & Homeland Security Appropriations, Taxation, Public Debt, Banking. Insurance, Retirement. & Land Utilities, Transportation, Public Works, & Veterans Affairs Assistant Majority Whip May29,2012 TO: FROM: SUBJECT: ALL SENATORS SENATOR DENNIS G. RODRIGUEZ, JR.~ CHAIRPERSON 2ND NOTICE OF PUBLIC HEARING 2ND NOTICE OF HEARING Friday, June1, :00PM In accordance with the Open Government Law, Public Law , relative to notice for Public Meetings. Please be advised that the Health & Human Services, Economic Development Senior Citizens and Election Reform will be conducting a hearing on June 1, 2012, at I Uheslaturan Gutihan's Public Hearing Room in Hagatfia, on the following: 12:00PM Resolution No (COR) Relative to requesting the United States Department of Health and Human Services Secretary Kathleen Sebelius to prioritize and approve the Guam Memorial Hospital Authority's request for relief of Medicare reimbursement rates under the Tax Equity and Fiscal Responsibility Act of 1982 and to express the dire and emergent situation the only civilian hospital on Guam faces due to the large disparity in collecting reimbursements from Medicare. (Introduced by D.G. Rodriguez, Jr.) Testimony should be addressed to Senator Dennis Rodriguez, Jr., Chairman, and may be submitted via- hand delivery to our office at 176 Serenu Avenue Suite 107 Tamuning, Guam or our mailbox at the Main Legislature Building at 155 Hesler Place, Hagatiia, Guam 96910, or via to senatordrodriguez@gmail.com. We comply with Title II of the Americans with Disabilities Act (ADA). Individuals who require an auxiliary aid or service (i.e. qualified sign language interpreters, documents in Braille, large print, etc.) for effective communication, or a modification of policies or procedures to participate in a program service, or activity of Senator Dennis Rodriguez, Jr. should contact Clifton Herbert at (TODU) as soon as possible but no later than 48 hours before this scheduled event. We look forward to your attendance and participation. For further information, please contact the Office of Senator Dennis Rodriguez, Jr. at (TODU) Ufisinan Todu Guam 31st Guam Legislature 176 Serenu Avenue, Suite 107, Tamuning, Guam 96931/Telephone: TODU (8638) /Facsimile: senatordrodriguez@gmail.com

23 c~ ii Joseph Anthony Mesngon Second Notice of Public Hearing 1 message Clifton Herbert <cherbert.senatordrodriguez@gmail.com> To: phnotice@guamlegislature.org Wed, May 30, 2012 at 9:25 AM Ufisinan Todu Guam S E N AT 0 R D E N N I S G. R 0 D R I G U E Z, Jr. I Mina'trentai Unu Na Liheslaturan Guiihan CHAIRMAN, COMMITTEE ON HEALTH & HUMAN SERVICES, ECONOMIC DEVELOPMENT, SENIOR CITIZENS AND ELECTION REFORM Dear Senators, Buenas yan Hafa Adai! Please see attached notice of public hearing. Should you have any questions or concerns, please feel free to contact this office at any time. Sincerely, Clifton Herbert 176 Serenu Avenue Suite 107 Tamuning, Guam Telephone: Cherbert.senatordrodriguez@gmail.com Website: This may contain data that is confidential, proprietary or non-public personal information, as that term is defined in the Gramm-Leach-Bliley Act (collectively, Confidential Information). The Confidential Information is disclosed conditioned upon your agreement that you will treat it confidentially and in accordance with applicable law, ensure that such data isn't used or disclosed except for the limited purpose for which it's being provided and will notify and cooperate with us regarding any requested or unauthorized disclosure or use of any Confidential Information. By accepting and reviewing the Confidential information, you agree to indemnify us against any losses or expenses, including attorney's fees that we may incur as a result of any unauthorized use or disclosure of this data due to your acts or omissions. If a party other than the intended recipient receives this , he or she is requested to instantly notify us of the erroneous delivery and return to us all data so delivered...., Senators 2nd Notice Public Hearing June 1, 2012.pdf w 66K 5/31/2012

24 - - - SENATOR DENNIS G. RODRIGUEZ, JR. Chairman, Health & Human Services, Senior Citizens, Economic Development, & Election Reform Public Safety, Law Enforcement, & jud iciary Comm ittee on Youth, Cultural Affairs, Procurement, General Government Operations, & Public Broadcasting Municipal Affairs. Tourism, Housing & Recreation Rules, Federal. Foreign & Micronesian Affairs, & Human & Natural Resources the Guam Military Buildup & Homeland Security Appropriations, Taxation, Public Debt, Banki ng. Insurance, Retirement, & Land Utilities, Transportation, Public Works, & Veterans Affai rs Assistant Majority Whip PRESS RELEASE SECOND NOTICE OF PUBLIC HEARING Friday, June 1, :00PM In accordance with the Open Government Law, Public Law , relative to notice for Public Meetings. Please be advised that the Health & Human Services, Economic Development, Senior Citizens and Election Reform will be conducting a Public Hearing on Friday, June 1, 2012, 12:00 P.M., at I Liheslaturan Guahan's Public Hearing Room in Hagatfia, on the following: 12:00PM Resolution No (COR) Relative to requesting the United States Department of Health and Human Services Secretary Kathleen Sebelius to prioritize and approve the Guam Memorial Hospital Authority's request for relief of Medicare reimbursement rates under the Tax Equity and Fiscal Responsibility Act of 1982 and to express the dire and emergent situation the only civilian hospital on Guam faces due to the large disparity in collecting reimbursements from Medicare. (Introduced by D.G. Rodriguez, Jr.) Testimony should be addressed to Senator Dennis Rodriguez, Jr., Chairman, and may be submitted via- hand delivery to our office at 176 Serenu Avenue Suite 107 Tamuning, Guam or our mailbox at the Main Legislature Building at 155 Hesler Place, Hagatfia, Guam 96910, or via to senatordrodriguez@gmail.com. We comply with Title II of the Americans with Disabilities Act (ADA). Individuals who require an auxiliary aid or service (i.e. qualified sign language interpreters, documents in Braille, large print, etc.) for effective communication, or a modification of policies or procedures to participate in a program service, or activity of Senator Dennis Rodriguez, Jr. should contact our office at (TODU) as soon as possible but no later than 48 hours before this scheduled event. We look forward to your attendance and participation. For further information, please contact the Office of Senator Dennis Rodriguez, Jr. at (TODU) Ufisinan Todu Guam Guam Legislature 176 Serenu Avenue, Suite 107, Tamuning, Guam /Telephone: TODU (8638) /Facsimile: senatordrodriguez@gmail.com

25 Joseph Anthony Mesngon 2nd Notice Public Hearing 1 message Wed, May 30, 2012 at 9:22 Clifton Herbert <cherbert.senatordrodriguez@gmail.com> AM To: clynt@spbguam.com, dcrisostomo@guampdn.com, dmgeorge@guampdn.com, dtamondong@guampdn.com, editor@mvariety.com, gdumat-ol@guampdn.com, gerry@mvguam.com, hottips@kuam.com, jason@kuam.com, john@kuam.com, jtyquiengco@spbguam.com, marvic@mvguam.com, mpieper@guampdn.com, mvariety@pticom.com, news@spbguam.com, nick.delgado@kuam.com, parroyo@ k57.com, ricknauta@ hitradio100.com, sabrina@kuam.com, slimtiaco@guampdn.com, therese.hart.writer@gmail.com, zita@mvguam.com, Amritha Alladi <aalladi@guampdn.com>, Arvin Temkar <aktemkar@guampdn.com>, "George, Duane M" <dmgeorge@guam.gannett.com>, gerry partido <gerrypartido.mvguam3@gmail.com>, James <officemanager@hitradio100.com>, Janela <janela@mvguam.com>, Jesse Lujan <jesselujan27@yahoo.com>, "Jon A. Anderson" <editor@mvguam.com>, Jr <news@lifenews.com>, Katrina <life@guampdn.com>, Ken Quintanilla <kenq@kuam.com>, Kevin Kerrigan <kevin@spbguam.com>, Kevin Kerrigan <news@k57.com>, Laura Matthews <llmatthews@guampdn.com>, Mindy Aguon <mindy@kuam.com>, Oyaol Ngirairikl <odngirairikl@guampdn.com>, Pacific Daily News <news@guampdn.com>, "rgibson@k57.com" <rgibson@k57.com>, Travis Coffman <thebigshow@k57.com>, William Gibson <breakfastshowk57@gmail.com> Bee: jmesngon.senatordrodriguez@gmail.com Hafa Adai All Media! Ufisinan Todu Guam S E N AT 0 R D E N N I S G. R 0 D R I G U E Z, Jr. I Mina'trentai Unu Na Liheslaturan Guiihan CHAIRMAN, COMMITTEE ON HEALTH & HUMAN SERVICES, ECONOMIC DEVELOPMENT, SENIOR CITIZENS AND ELECTION REFORM Please see attached notice of public hearing. Should you have any questions or concerns, please feel free to contact this office at any time. Sincerely, Clifton Herbert 176 Serenu Avenue Suite 107 Tamuning, Guam Telephone: Cherbert.senatordrodriguez@gmail.com Website: This may contain data that is confidential, proprietary or non-public personal information, as that term is defined in the Gramm-Leach-Bliley Act (collectively, Confidential Information). The Confidential Information is disclosed conditioned upon your agreement that you will treat it confidentially and in accordance with applicable law, ensure that such data isn't used or disclosed except for the limited purpose for which it's being provided and will notify and cooperate with us regarding any 5/31/2012

26 requested or unauthorized disclosure or use of any Confidential Information. By accepting and reviewing the Confidential information, you agree to indemnify us against any losses or expenses, including attorney's fees that we may incur as a result of any unauthorized use or disclosure of this data due to your acts or omissions. If a party other than the intended recipient receives this , he or she is requested to instantly notify us of the erroneous delivery and return to us all data so delivered. 2 attachments ~ Public Hearing 2nd Notice June 1, 2012.pdf 386K :!!) Public Hearing 2nd Notice June 1, 2012.doc 546K 5/31/2012

27 SENATOR DENNIS G. RODRIGUEZ, JR. Chairman, Health & Human Services, Senior Citizens, Economic Development, & Election Reform Public Safety, Law Enforcement, &Judiciary Youth, Cultural Affairs, Procurement, General Government Operations, & Public Broadcasting Municipal Affairs, Tourism, Housing & Recreation PUBLIC HEARING AGENDA Friday, April 1, pm Public Hearing Room, I Liheslatura I. Call to order II. Item for public consideration: A. Resolution (COR)- Relative to requesting the United States Department of Health and Human Services Secretary Kathleen Sebelius to prioritize and approve the Guam Memorial Hospital Authority's request for relief of Medicare reimbursement rates under the Tax Equity and Fiscal Responsibility Act of 1982 and to express the dire and emergent situation the only civilian hospital on Guam faces due to the large disparity in collecting reimbursements from Medicare. ill. Adjournment Rules, Federal, Foreign & Micronesian Affairs, & Human & Natural Resources the Guam Military Buildup & Homeland Security Appropriations, Taxation, Public Debt, Banking, Insurance, Retirement, & Land Utilities, Transportation, Public Works, & Veterans Affairs Assistant Majority Whip Ufisinan Todu Guam 31st Guam Legislature 176 Serenu Avenue, Suite 107, Tamuning, Guam /Telephone: TODU (8638) /Facsimile: senatordrodriguez@gmail.com