"I hope this year the President will agree that more major Medicare reforms are needed to save rural health care. However, these new changes signal that we are making progress. We have more work to do, but are making progress."

The list of Medicare changes that went into effect as of January 1, 2000 are as follows:

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; adopts a more flexible schedule for patients in rural areas to remain in the hospital for longer; and allow hospitals that closed or downsized within the last 10 years to convert to Critical Access Hospitals to serve Medicare patients.

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 immunosuppressive 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.  
 
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 package.  Congress will provide an additional $3.3 billion to M+C plans to increase their benefit options as well as receive incentive bonuses to enter markets that currently do not offer a Medicare+Choice plan to seniors.

Lower Out-of-Pocket Costs for Seniors. Effective January 1, 2000, 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, will be limited to the same amount as the deductible for inpatient care ($776 in 2000).

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.

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.  The Secretary of Labor has been directed to establish a process where a health care provider could increase therapy for Medicare patients based on individual need.

Improved Care for 22 Million Older Women. Older women will now have greater access to Pap smear tests and cervical cancer screening technologies for 22 million Women on Medicare. Effective January 1, 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.

Prostate Cancer Screenings Added as New Benefit for 18 Million Older Men. Medicare now offers free prostate cancer screenings to beneficiaries.  Congress added breast, colon and cervical cancer screenings as new preventive care measures in 1997.

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 and nursing homes each year. 

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 with correspond to levels of care for seniors.  Congress updated this payment rates this year to better reflect current inflation rates.

"I am encouraged by these Medicare changes and know that the coming year will bring more work and more reform to Medicare that will benefit Pennsylvania's rural patients."