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House hearing: CEOs defend rural missions, cite unpaid MA claims and uncompensated care
Summary
Hospital leaders told the House Ways and Means Committee that unstable coverage, unpaid Medicare Advantage claims and administrative complexity are major cost drivers; lawmakers pushed for site‑neutral payment and better oversight of rural reclassifications and 340B.
House Ways and Means Committee members pressed hospital and health system CEOs on May 13 about why hospital prices keep rising and how federal payment rules and practice changes have affected access. Key witness claims included: HCA’s Sam Hazen saying HCA provided about $4.5 billion in uncompensated care last year; CommonSpirit’s Wright Lacader describing roughly $4.3 billion in unpaid Medicare Advantage claims; and Protect Our Care’s Brad Woodhouse alleging that the recent federal tax/health bill (HR1) has already led to closures and wide risk across hundreds of facilities. Lawmakers asked for more transparency about tax‑exempt community benefits, the 340B program's use, and how CMS rural referral designations are applied.
Committee members signaled interest in legislation or oversight on site‑neutral payments for outpatient services, MA prompt pay rules, and rural funding safeguards. The hearing included extended exchanges about prior authorization, workforce shortages, and whether urban systems have abused rural designations.
