Serving Central Oregon since190375
FRIDAY November7,2014
OLYMPIC SNOWBOARDER KENT CALLISTER I SPORTS • C1
'so season, u e'ssi in eair bendbulletin.com TODAY'S READERBOARD Kitzhaber —Thenewly
re-elected governor is staying upbeat despite the CoverOregon failure and controversy surrounding his fiancee.B3
Pilot ButteInn'soldfireplacewil beacenterpiece oncemore BUSINESS • C6
School boundariesCrook County is preparing to change boundaries aheadof new school openings.B1
Compaint
MEDICARE
fied over
Heating —Neighborlmpact's Home EnergyAssistance Program helps low-income residents stay warm in thewinter months.B1
Roats'
residency
Ebnla dOCtOr —Kent Brantly is Ebola-free and roaming the U.S., giving blood and dispelling fear.AS
By Tyler Leeds The Bulletin
Casey Roats won a seat on the Bend City Council
Babies' diets —Astudy suggests that infants' diets reflect the socioeconomic status of their parents.A3
And a Web exclusiveIn the weeksafter Michael Brown's shooting, Ferguson leaders and their families were targets of computer hacking. bendbenetin.cem/extras
EDITOR'5CHOICE
A Meda of Honor,
151 years afterward
By Tara Bannowe The Bulletin
on Tuesday despite questrons over
Roets courtstostop the councilor-elect from be-
That's because of Medicare rules around so-called critical access hospitals — smaller, rural facilities that get a special boost from the government to ensure they can keep their doors open.
Out-of-pocketcostsvary acrossCentral Oregonhospitals
St. Charles Madras and Pioneer Memorial Hospital in Prineville are among the more than 1,300 hospitals nationally that fall under
Medicare patients are required to pay out-of-pocket charges for most outpatient services they receive.
Those chargesarehigher at critical access hospitals (Madras and Prineville) than at acute carehospitals (Bend andRedmond).
this designation. St. Charles
OUT-OF-POCKETCHARGES • to Medicare patients for common outpatient services at hospitals, 2012 •
Bend and Redmond are part of a larger group of hospitals called acute care hospitals.
Critical access hospitals are small — they can have no more than 25 beds — and ru-
ral — they have to be at least 35 miles from another hospital. They operate under re-
•
Th e rapeutic prophylactic or diagnostic injection; IV push
Note: Actual charges can vary depending on the specific patient
$66.60 Out-of-pocket chargeat
Average out-of-pocket chargeat acute care hospitals, such as
St. CharlesMadras"
•
Bend andRedmond $25.33
Si
and common conditions.
New York Times News Service
More complicatedcases are
WASHINGTON — After
referred to larger hospitals. Medicare beneficiaries
** Pioneer Memorial Hospital in Prineville is also a critical access hospital, but was not owned by St. Charles during the time period studied
who visited critical access
Source: St. Charles Health System, U.S. Departmentof Health & Human Services Office of Inspector General A ndy Zeigert/The Bulletin
hospitals were charged two to six times as much for common outpatient services compared with those who visited
acute care hospitals, the U.S.
presented the Medal of
Department of Health and
Honor to the family of Cushing, a Union soldier
Human Services Office of InspectorGeneral determined
who died at the Battle of
in a report released last month. The report used data from 2009 and 2012 and cited statistics from other years. In 2011, Medicare benefi-
erate fire.
"His story is part of our larger American story,
services at critical access
hospitals. The amount Medicare beneficiaries paid grew by 2 percentage points between 2009 and 2012, the report said. Karen Shepard, chief financial officer for St. Charles Health System, said depend-
buff whose house sits on
land once owned by Cushing's father. At the time of Cushing's death, the medal was not awarded posthumously, so he was ineligible. But even the White House announcement in August did not end the tale. At that point, the Penta-
gon had to figure out who would receive the medal on
Cushing's behalf. See Medal of Honor/A5
access hospitals were charged two to six times as much for common, outpatient services compared with those who visited acute care hospitals, the U.S. Department
By Joby Werrick The Washington Post
The Navy SEAL who fired the shot that killed Osamabin Laden is a
highly decorated veteran of the wars in Iraq and Af-
ghanistanwho agonized for months over whether to publicly reveal his role in
Laden's Pakistan hideout on May 2, 2011. In a recent in-
System. OPPS bases its num-
Medicare instead reimburses
terview, O'Neill confirmed to The Washington Post
them 101 percent of whatever it cost them to provide the
that he fired the fatal shot that struckbin Laden inthe
ed. The amounts Medicare
bers on the estimated cost of providing services, although many providers argue that
care.
forehead.
reimburses providers for
the OPPS rates are less than
time to compare what they would pay, but that's not always possible.
pocket costs for outpatient
Medicare beneficiaries who visited critical
Bin Laden's shooter revea s his identity
access hospitals, however, are not subject to OPPS rates.
paid an average of $400 more in coinsurance than they would have had they visited acute care hospitals, according to the OIG report. In the following year, they paid nearly half of the estimated $3.2 billion in out-of-
No other U.S. soldier awarded the nation's top military honor has had to wait as long for the decoration. Obama approved the medal this year, after a quarter-century lobbying campaign by advocates, led by Margaret Zerwekh, 94, a Wisconsin history
SeeRoats /A4
the providers' cost. Critical
access hospitals nationwide
in uniform."
partner of Barb Campbell.
in a database called the Outpatient Prospective Payment
tients could potentially check
Obama said at a ceremony
our brave men and women
political activist who is the
outpatient services are listed
ing on their situation, pa-
one that continues today,"
determination that he demonstrated lives on in
ty Circuit Court one day after the election by Bend attorney Charlie Ringo. The complaint was filed on behalf of Foster Fell, a
one of the most storied com-
with the hospitals ahead of
spirit, the courage, the
with the Deschutes Coun-
of Health and Human Services Office of Inspector General determined in a report released last month.
ciaries who visited critical
in the Roosevelt Room of the White House. "The
ing certified as the winner. A complaint was filed
In travenous infusion • Ca rdiac rehab/monitor Hy drate IV infusion add-on • Ai rway inhalation treatment
strictions that limit how long
people can stay so that they
others have
askedthe
compared with those in Bend or Redmond.
By Peter Baker
Gettysburg after standing up to a fusillade of Confed-
was eligible to run, but
that your outyatient hospital bills will be higher if you visit the facilities in Madras or Prineville
can focus on outpatient care
more than 151 years, 1st Lt. Alonzo H. Cushing got his day at the White House, even if he could not enjoy it personally. On Thursday, President Barack Obama formally
whether he
If you're a Medicare beneficiary who lives in Central Oregon, you might be surprised to learn
"A lot of these things could
be done as the result of an emergency visit," she said. The reason for the cost dif-
ference is slightly complicat-
mando operations in U.S. history. Robert O'Neill, 38, a Montana native, was near the head of the column of U.S. soldiers thatburst into bin
SeeMedicare/A4
SeeShooter/A5
T emi terms'rea winner: Hi aryCinton By Amy Chozick New York Times News Service
will seek advice from such farflung advisers as the adman
In the coming weeks, Hillary Rodham Clinton will stop delivering paid speeches. She will
behind the iconic "Don't Mess
embark on an unofficial listen-
ingtour to gather ideas from the business community, union
leaders and others. And she
TODAY'S WEATHER w<r~r
Mostly sunny High 57, Low31 Page B6
ANALYSIS
mine what the midterm results could mean for the presiden-
With Texas" campaign and a
has put fresh urgency on Clinton's efforts to create ablue-
leading strategist at a Boston
print for a 2016 presidential
public affairs consultancywith ties to the Kennedys.
candidacy, including scoping
tial electoral map. A number of advisers saw only upside for Clinton in the party's midterm wipeout. Be-
out White Plains, New York, as a possible headquarters and
fore then, opinions had been mixed about when she should
digesting exit polls to deter-
form an exploratory com-
The Democratic debacle in
'Itresday's midterm elections
INDEX 01-6 Classified E -f 6 Dear Abby All Ages D5 Obituaries B5 C5-6 Comics/Pu zzles E3-4 Horoscope Business D5 Sports C1-4 Calendar I n GO! Crosswords E 4 L o cal/State B 1-6 TV/Movies 05, GO!
The Bulletin Anindependent Newspaper
Voc 112, No. 311, 30 pages,
e sections
mittee, the first step toward
declaring a presidential candidacy, with some urging her to delay it until late spring. But, over the past few days, a consensus formed among those close to Clinton that it is time to accelerate her schedule. SeeClinton /A4
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