Evening star., 1952-01-11
Back of the CHI Rate Increases
Hospital Care Away From D. C.
LiberoIized for Subscribers

Tor 3U Gays OF full protection a
year. But this 80 days could be
used in one disqualification period.
In addition, the plan previously
paid SO per cent Of the cost Of
"a semiprivate room for another
180 days-rather than the present
SIS a day cash allowance.
Changes Held Beneficial.
CHI contends the change is a
broadened benefit, since it per-
|mitS full protection against more
than one period Of lengthy hos
pitalization. No substa. ltial diff
ference in cost is involved.
In other changes:
/. CHI will grant q $10-a-day
allowance toward the cost o: a
private room, if the patient elects
not to stay in a fully paid semi
private room.
Previously, CHI in such cases
credited the patient with the cost
of the highest-price semiprivate
room. In most hospitals, this ex-
ceeds $40 day. CHI, for the
first time, also defined a semi
private" room as one occupied by
two. three or four patients.
2. GHI's payments for hospital
services will include "all drugs and
medicines listed in the official
|formularies."
Previously. CHI made no ref
|erence to whether drugs were list
led in the official pharmaceutical
formularies. The only significant
new drug excluded by this provi-
sion, officials said, is the new anti
biotic. terramycin.
Along with the revised benefits
new contracts. now are being
signed by CHI and 81 hospitals
in the Washington area. They
Iprovide that CHI shall pay hos
lpitals for services given CHI pa
Itients on basis of 95 per cent
of the hospitals normal charges
for those services.
Year-End Adjustments.
At the end of each year, the
contracts provide for financia
adjustments ~ either upward OF
downward according to a for.
mula based both on the hospitals
charges and their actual costs.
The hospitals, under the con.
tracts, agree to set up unified
cost-accounting systems. The con.
tracts provide that the. systems be
set up within six months of the
contract date, or that hospitals
face per cent penalty Of GIL
payments due.
CHI, in addition to it's hospita.
prepayment plan, acts as admin.
istrative agent for Medical Service
| of the District Of Columhia-the
so-called surgical plan" set up by
the District Medical Society.
Under this plan, a schedule oi
fees for participating doctors Il
set up for each surgical procedure
If subscribers incomes are below
certain levels, their surgical bills
are covered completely by the
scheduled fees. # their incomes
are higher. doctors can make ad-
dltional charges to the patients
Surgical Plan Changes.
Ofiicials announced last week
that income levels have beer
raised from $4,000 to $4,000 fol
unmarried subscribers. and $4.50G
to $500 for those with family
contracts. In addition new fee
schedules are being set up which
will increase benefit allowances
by about 20 per cent for SUBJ
scribers whose incomes exceed the
ceilings.
The surgical plan also an
nounced that. for the first time,
certain services covered by the
insurance plan may be performed
| In homes or In doctors Offices.
Medical Service did not raise
the $1-a-month rate of its in
dividual contracts. Rates for fam
lily contracts were raised from
$2.70 to $500.
The surgical contracts are
available only to those who also