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January 7, 2000 
Washington, D.C.— In a ongoing effort to keep Nevadans informed of changes in federal programs, U.S. Congressman Jim Gibbons (R-NV) today announced that the New Year has ushered in several changes in Medicare to reduce seniors’ out-of-pocket costs and improve their access to preventive care, home health, rural hospitals, rehabilitation therapy and innovative new drugs.

“This New Year, seniors in Nevada can celebrate a new century starting with Medicare at lower out-of-pocket costs, a longer life expectancy for the Medicare trust fund until 2015, and increased access to critical health care that beneficiaries need to live long and productive lives,” said Gibbons.  “Last year, Congress cut out-of-pocket costs for seniors and offered them more choices than ever before.  This year, we’ll try again to strengthen and improve Medicare and expand benefits such as prescription drugs for those elderly and disabled who need help the most.”

1.   Lower Out-of-Pocket Costs for Seniors.  Effective January 1st, seniors’ out-of-pocket costs for hospital outpatient care, which currently vary widely and often exceed Medicare’s standard 20 percent co-pay by hundreds of dollars, will be limited to the same amount as the deductible for inpatient care -  $776 in 2000. 

2.   Prostate Cancer Screenings Added as New Benefit for 18 Million Older Men.  Thanks to action taken by Congress in 1997, effective January 1, 2000, Medicare began offering free prostate cancer screenings to beneficiaries.  Congress added breast, colon, and cervical cancer screenings as new preventive care measures for beneficiaries in 1997.

3.   Expanded Access to Innovative Drugs - Medicare patients will have continued access to new technologies and drugs, including orphan and cancer drugs.  Medicare’s coverage of immuno-suppressive drugs was also expanded to improve kidney and other organ transplant survival rates.  Prior to this year, Medicare covered drugs for immunosuppressive drug therapy during the first 36 months following an organ transplant.  Congress provided an additional $150 million to extend that time limit an additional 6-8 months.

4.   Improved Health for 22 Million Older Women.  Passed by Congress last year, the Medicare Balanced Budget Refinement Act provides greater access to Pap smear tests and cervical cancer screening technologies for 22 million women on Medicare.  Prior to the new law, Medicare paid for Pap smears under the clinical laboratory fee schedule.  Effective January 1st, Congress set a minimum payment for the test component of a Pap smear at $14.60, thereby increasing reimbursements to labs and enhancing access for women.

5.   More Health Care Options for Seniors.  Six million seniors will be offered more benefits as Medicare+Choice plans will now be allowed to vary their benefit packages.  Thanks to efforts by Congress last year, M+C plans will receive an additional $3.3 billion to increase their benefit options as well as receive incentive bonuses to enter markets that currently do not offer a Medicare+Choice health plan to seniors.

6.   Additional $1 Billion to Strengthen Rural Hospitals.  Congress provided an additional $1 billion to strengthen rural hospitals, ensuring that vital health care remains accessible for seniors in rural areas.  Additionally, the new Medicare changes extend the Medicare Dependent Hospital (MDH) program for rural areas; adopt a more flexible schedule for patients in rural areas to remain in the hospital longer, and; allow hospitals that closed or downsized within the last 10 years to convert to Critical Access Hospitals to serve Medicare patients.

7.   Improved Rehabilitation Services.  New Medicare changes repeal the $1,500 therapy caps for two years for nearly 2 million seniors receiving occupational therapy, and the $1,500 physical and speech therapy caps.  Previously, annual payment limits were capped for all outpatient therapy services provided by non-hospital providers at $1,500 per therapy.  Congress repealed the caps and directed the Secretary to establish a process where a health care provider could increase therapy for Medicare patients based on individual need.

8.   Better Home Health Care Services.  Provides greater access for the nearly 4 million seniors receiving health care at home by increasing payments until a new payment system for home health is fully implemented.  Medicare also will begin assisting agencies with added paperwork and record-keeping costs, and increase per beneficiary limits for efficient agencies.

9.   More Treatment for High-Acuity Patients in Nursing Homes.  Last year, Congress  added an extra $1.4 billion for caring for 2 million medically-complex patients that enter skilled nursing facilities (SNFs) and nursing homes each year.  The added funding targets four specific categories classifying the medical needs of patients. 

10.   Better Hospice Care.  Over 300,000 terminally-ill patients will have better access to hospice care.  Hospice payments are based on one of four prospectively determined daily payment rates which correspond to levels of care for seniors.  Congress updated those payment rates this year to better reflect current inflation rates.

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