Associated Press
Tuesday, March 18, 2003
Health providers skeptical of state schemes
to raise federal money
By Jennifer Peter
Massachusetts' nursing homes thought they had a deal with
the state last year.
They would pay the state an additional $9.60 daily fee for
most of their patients, and the state would parlay that into federal matching funds that
would be poured back into the ailing industry.
The Romney administration's recent decision to keep that
federal money for other uses, at least for three months, has shaken health care providers'
confidence in this method of raising money during tough financial times.
In the latest instance, Health and Human Services Secretary
Ron Preston floated the idea of luring more federal money into the state's free care pool by
charging the state's hospitals an additional assessment. The pool pays for
health care for the uninsured.
"The track record of the state in living up to these
commitments is what troubles the hospitals the most," said Dennis Keefe, acting chief executive
officer of Cambridge Health Alliance. "Similar commitments were made to the
nursing home industry and the commitment was not stuck to."
The federal government sends Massachusetts 50 cents for
every dollar from the free-care pool that is sent to acute hospitals, or about $150 million to $160
million each year.
Most years, only $30 million of that is sent back into the
free care-pool. During the past two fiscal years, the state increased that amount to about $75 million.
But Gov. Mitt Romney has proposed reducing the amount back to $30 million
for fiscal year 2004.
"Fool me once, shame on you. Fool me twice, shame on me,"
said Massachusetts Hospital Association President Ron Hollander, about the
industry's resistance to a new assessment.
Last year, the Legislature approved a plan requiring nursing
homes to pay an additional $9.60 daily user fee for each non-Medicare patient, bringing in an
estimated $145 million. The state would return most of this to the nursing
homes, to cover the user fee for the state-supported Medicaid patients.
This expenditure would be matched by the federal government dollar-for-dollar.
"This plan was supposed to infuse the system with seriously
needed money when the state was not able to make the investment itself," said Ernie
Corrigan, spokesman for the Massachusetts Extended Care Federation. "The
intent of the legislation was not to benefit the state or the general treasury. It
was to make the an investment into the long-term health care system in
the state."
Administration officials said the delay in reinvesting the
federal money is part of an overall budget-balancing plan that required all health care providers to
make sacrifices. They also emphasized that the plan had been delayed, not
implemented.
"What we tried to was to ... allocate the shortfall in the
most equitable and fair way possible," said Douglas Brown, acting commissioner of the Division of
Medical Assistance. "While the nursing home industry is legitimately not happy
about that, I can tell you that no provider group is happy about what the state
has had to do. No one could have predicted the fiscal emergency we're in."
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New Bedford Standard Times
Monday, March 17, 2003
Fee hikes just a 'tax,' register of deeds says
By Steve Urbon, Standard-Times senior correspondent
Gov. Mitt Romney has already broken his "no new taxes"
pledge, as far as Bristol County Register of Deeds J. Mark Treadup is concerned.
Starting today, Mr. Treadup's office and the 12 others like
it in Massachusetts will begin charging sharply increased filing fees for documents, fees that will
funnel hundreds of millions of dollars back into the state treasury and a relative
trickle back to the registries.
The governor signed the revenue-raiser into law last week,
causing jubilation at certain registries that have been swamped with work during the current wave
of mortgage refinancing. The Middlesex Registry of Deeds in Cambridge
immediately announced it would use its share of the new money to extend its
hours to accommodate the rush.
But Mr. Treadup argues that the registries were already
collecting far more money than they need to operate, and that hiking the fees is nothing more than
a thinly disguised tax increase.
In his case, the registry office in New Bedford has an
annual budget of about 14 percent of the $4.6 million it collected last calendar year from people filing
documents. While that doesn't include heat and electricity in the county-owned
building, it still means that the registry is a very lucrative source of revenue for
the state and the county. Mr. Treadup produced a set of quarterly checks to
the county and state for tens of thousands of dollars each.
Gov. Romney has contended since the campaign that fees -- as
opposed to taxes -- should be raised high enough to cover the cost of providing the specific
services involved. "We must also reset fees that are out of line," he said in his
State of the State address last month.
Yet the registry of deeds fees are disconnected from the
registry's budget, which is set separately and funded by a line item far smaller than the money
the system takes in.
For people buying homes or refinancing, next week's
increases will be something of a shock.
The price for filing a deed, which is now $45, will leap to
$125.
The cost of filing a mortgage will increase from the current
$40 to $175. Since those who are refinancing must also file for a mortgage discharge on their old
note, the have to pay another $75. The current discharge fee is $30.
It is the same down the line. A declaration of homestead, an
affidavit that shields homeowners from creditors who might otherwise attempt to sell their
homes out from under them, was $10. Starting today it will be $35.
The new fees for almost every category of filing include an
existing $20 charge for the community preservation fund, through which towns can apply for
matching funds for land preservation and low-income housing. They also
include a new $5 fee for a technology fund that will finance improvements at
the registries.
Even copying fees will increase.
Davis Howes, an attorney at Prescott, Bullard and McLeod of
New Bedford, is a regular sight at the Registry of Deeds. As far as his firm is concerned, the new
fees "are just a pass-through," although they might irritate clients writing
checks at closings. Where the typical filing fees for a simple house purchase now
cost the buyer $95, that will jump to $300.
Susan Borges, a title examiner, said she believes the fee
system is especially unfair to people purchasing property that is partly registered land --
boundaries certified by the land court -- and recorded land, which is not. Such
people will pay all of the fees twice, once in each category.
"The fees are reasonable now," she said.
Reasonable or not, the new fees will be a major source of
revenue for the state, especially as long as the heavy traffic of refinancing continues. The state
estimates the new fees, or taxes, will bring in $200 million a year. Mr. Treadup
thinks that the number is closer to $600 million.
And he still thinks they are taxes.
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