European Stars and Stripes (Newspaper) - September 01, 1985, Darmstadt, Hesse                                Page 4 the stars and stripes sunday september 1. 1985 new medicare payment rules published 86 Rafes expected to save $1.8 billion Washington health and human scr ices Secretary Margaret m. Heckler a s the fryc a on medicare Hospital reimbursement rates for 9xf will save More than  billion without reducing the Quality of care fur inc i lion s elderly. Heckler promulgated the final rules Friday that will make that free a official. The Reagan administration proposed the rules in june and first signalled that i wanted to hold the line on medicare rates last february in its proposed budget for fiscal j9h6. The rules also move medicare a step closer toward completing the three year phase in of its so called prospective payment system under which hospitals arc paid fees set in Advance for various ailments regardless of How lung the patient actually stays in the Hospital. There have been complaints that hospitals have been discharging medicare patients prematurely to save Money. Heckler said the prospective payment system is a Bright Feather in lie president s Cap. To maintains Quality care while helping to reduce the massive Federal deficit even As it ensure inc solvency of the medicare Trust  there Wil be no Adverse Impact on beneficiary Quality of care she said. Under the new rules medicare will pay the hospitals in fiscal 1986 starting oct. I at rates based 75 percent on Federal payment Levels and 2s percent based on each Hospital s historic costs. Under the first year of prospective payment hospitals were reimbursed 25 percent on the Federal payment rates and 75 percent on their own traditional costs. In the past year the rates were determined on a 50-50 mix. Starting in fiscal 1987, Hospital reimbursement will be based solely in of ral payment Rales without regard for specific Hospital historic costs the department said. In her Staic mini heckler said the department has a two year track record of Success behind us. We have brought medicare Hospital expenditures under control while ensuring that medicare beneficiaries receive the highest Quality medical care for their  the final rules putting the freeze into effect will appear in the Federal Register on tuesday. The government in first proposing the freeze said that because of past overpayment a 2,85 percent Cut in the payment rates for 1986 could be justified. But it finally ruled that out saying a Cut would have Adverse effects on hospitals and the development and acceptance of the prospective payment  heckler said the 1986 reimbursement rates for individual hospitals May increase or decrease depending on the Hospital s historic costs the ind a of Hospital wages and the Case mix of medicare Patio arts. Prospective payment now covers 5,405. Or 81 percent of the hospitals certified uhf Irovic care under medicare. Some states with their own Cost control programs were allowed to continue to follow their own reimbursement this big Piggy did t want to go to Market police officers in Hastings neb., try to contain a Bali Greenl 500-Pound hog that lumped from a pickup truck and ran Loose for two blocks before stopping to rest near a Bane trance. At right Adams county Deputy Mike Shada readies a second rope noose As police officer Paul Weber Center and Jim Kimminau move in. Kimminau from Lawrence neb., was taking six bogs to Market when this one decided to Lake a tour of Hastings. Tort new rules also 9 provide no increase in the target limitations on re info Nursement for rehabilitation psychiatric and other Ospil als excluded from the prospective payment system. Include a new wage Index based on a government Survey that takes into account regional differences in hospitals use of part time employees. The Index is retroactive to ocl. 1, 1983. Modify certain diagnosis related groups the 470 different diseases around which medicare bases its payments. Update the diagnosis related groups to reflect changes in technology. Revise the method used to count interns and Resi dents in calculating indirect medical education payments to teaching hospitals. Reagan order delays possible Railroad strike Santa Barbara Calif. Of president Reagan invoked a two month Cooling off period under the National railway labor act on Friday to head off a threatened National Railroad strike. The president issued an executive order establishing an emergency Board to attempt to resolve the labor management dispute. His action has the effect of de laying any possible strike for at less two months. The situation appears to the president to be car Emily critical the White House press office said in a statement. The Impact of a nationwide Railroad strike would have an immediate effect on the Public the while House said. In addition it Slid a strike would Idle hundreds of thousands of employees and halt the flow of $750 million Worth of goods each Day. The Board will investigate and make recommendations for settlement of a Dis Pute Balw Cecii the United transportation Union and most of the nation s major railroads that arc represented by the National railway labor conference. The Board has 30 Days to report its findings to the president after which the parties will have 30 Days to consider the recommendations and attempt to resolve their differences. The announcement said that although Amtrak is not a party to the dispute in passenger service might be curtailed be cause it contracts with other railroads for train and engine Crews. Reagan will fight any depression making Bill Santa Barbara Calif. A president Rea Gan equating protectionism with destruction ism sat urday pledged to fight any Trade tax or farm legislation that docs not meet the test of advancing America s pros  in his weekly radio address delivered from his ranch in the Santa Ynez mountains North of Here Reagan said . Economy has created about 7.5 million jobs since 1980, despite mounting Trade deficits. Let s Challenge ourselves to create 10 million More in the next four he said. Reagan defended his decision to reject quotas or higher tariffs on imported shoes saying such protectionist Mea sures entail huge hidden  instead of protectionism we should Call it destruction ism Reagan said. Noting that Congress is awash in Bills calling for Trade sanctions and retaliation the president said if Congress crafts a depression making Bill. I la fight it whether it islam Trade or farm legislation. Any tax hike or spending Bill or protectionist legislation that does not meet the test of advancing America s Prosperity must and will be of  Reagan repealed however that his administration will employ every Legal recourse available to give american manufacturers a fair shake at Home and open markets  democratic rep. Morris Udall of Arizona delivering his party s response to the president s remarks said Rea Gan was to blame for the mounting Trade deficit which he called a loaded gun threatening american jobs. He said Steps must be taken to reverse the Trade imbalance and if the president will not take action con Gress certainly  if moderate and responsible Steps arc not taken soon the Trade deficit will claim still More victims and next year even More workers will be celebrating labor Day inthe unemployment lines Udall said. Reagan will return to Washington on monday after speech in Independence to. The current Holiday brings to 209 Days the time Reagan has spent at his ranch since becoming president. He was last there in february and cancelled a planned 10-Day visit in july because of the Twa hijacking crisis in the Middle East. Reagan was operated on for cancer of the Colon seven weeks ago and doctors said at the time he should be recovered from the operation in six to eight weeks