10-16-2000

POLITICS & POLICY - MEDICARE I: GIVEBACK BILL WOULD ALSO EXPAND BENEFITS

 
      A bill designed to return Medicare funding to providers and
 payers would also expand coverage for preventive care and limit
 the out-of-pocket cost of outpatient services for Medicare
 beneficiaries, the New York Times reports.  Expected to cost
 between $26 billion and $28 billion over five years -- two-thirds
 of which would go to health care providers and Medicare HMOs --
 the legislation is currently "sailing through Congress with
 bipartisan support."  Among other benefits, the bill would:  
   o  Limit the amount that can be charged to beneficiaries for
      outpatient care to 60% next year, 55% in 2002 and 2003, 50%
      in 2004, 45% in 2005 and 40% in 2006 -- reductions that
      would save beneficiaries an estimated $1.8 billion.  In
      recent years, "a quirk in the Medicare law" has forced
      patients to pay a "rapidly growing" share of outpatient
      services;
   o  Cover colonoscopies for all beneficiaries, rather than just
      for people who have a high risk of developing colon cancer
      as under current policy;
   o  Cover routine glaucoma screening for people with a high risk
      of the disease, rather than providing no coverage for
      routine glaucoma examinations as under current policy;
   o  Expand coverage of Pap smears and pelvic examinations from
      once every three years, as is current, to once every two
      years;
   o  Cover, for the first time, "medical nutrition therapy
      services" for patients with diabetes or kidney disease; the
      government will also study whether to extend coverage to
      other groups;
   o  Eliminate the 44-month time limit on coverage of drugs taken
      to prevent rejection of organ transplants.The New York Times
      reports that "Republicans said they had decided" to provide
      the new benefits for two reasons. 
 
 First, they said, such preventive care can "prolong the lives of
 older Americans."  And second, the benefits "serve an important
 political purpose, showing that members of Congress care about
 older voters even as lawmakers respond to the pleas of lobbyists
 for the health care industry."  The bill would also establish
 minimum payments of $525 per month for Medicare HMO beneficiaries
 in metropolitan areas with populations of more than 250,000 and
 $475 per month in rural areas.  Rates currently vary from $402
 per month in some rural areas to $814 in parts of New York. 
 (Pear, New York Times, 10/15).
 



American Healthline