FOR IMMEDIATE RELEASE CONTACT: (202) 225-3625
November 18, 1999
No. FC
17-A
Congressman Bill Archer (R-TX), Chairman of the Committee on Ways and Means, announced the conference agreement on Medicare provisions incorporated by reference into H.R. 3194, the "District of Columbia Appropriations Act," which were introduced as H.R. 3426, the "Medicare, Medicaid, and SCHIP Balanced Budget Refinement Act of 1999." These provisions were also substantially included in H.R. 3075, which passed the House on November 5, 1999, by a vote of 388-25.
DESCRIPTION OF THE CONFERENCE AGREEMENT ON THE "MEDICARE, MEDICAID, AND BALANCED BUDGET REFINEMENT ACT OF 1999":
REDUCES SENIORS' COSTS: Seniors' out-of-pocket costs for hospital outpatient care, which currently vary widely and often exceed Medicare's standard 20 percent co-pay, would be limited to the same amount as the deductible for inpatient care - $776 in 2000.
MEDICARE+CHOICE: The conference agreement would create incentives to expand Medicare+Choice options for seniors by increasing payments to Medicare+Choice plans, would slow down the phase-in of the risk-adjuster until the system could be revised with more complete data, and would offer incentives to encourage plans to begin offering coverage to seniors in counties that do not currently have Medicare+Choice plan options available. The bill would also allow plans to offer seniors more choices by varying benefit packages, would allow a Medicare+Choice plan to offer continuing coverage to seniors even if the plan withdraws from their immediate county of residence, and would establish more flexible enrollment options for the frail elderly.
ORGAN TRANSPLANT PATIENTS: The conference agreement would extend Medicare's coverage of anti-rejection drugs used after organ transplants beyond the current three-year limit.
REHABILITATION SERVICES: Under the conference agreement, annual rehabilitation therapy caps would be lifted entirely for two years but with safeguards to prevent fraud and abuse.
WOMEN'S HEALTH: The conference agreement would provide more access to pap smear tests and cervical cancer screenings.
RURAL HOSPITALS: The conference agreement would increase flexibility in determining payment status and flexibility of rural hospital bed use (swing beds), would extend the Medicare Dependent Hospital program for rural areas, would provide financial relief to sole community hospitals, and would modify the existing Rural Hospital Flexibility Grant program to permit rural hospitals to obtain computer software and staff training to accommodate changes to new payment systems.
CANCER HOSPITALS: The conference agreement would ensure that cancer hospitals would not face any reductions due to the new outpatient prospective payment system (PPS).
HOSPITALS: The conference agreement would ensure smooth transition for hospitals switching to Medicare outpatient PPS - creating "outlier" adjustments to ensure continuing access to new technologies and drugs, including orphan/cancer drugs, and would provide targeted incentives to increase hospital efficiency and ease the transition to the new PPS. Rural hospitals with less than 100 beds would receive additional protections as they transition to the new payment system.
NURSING HOMES: Skilled nursing facilities would be given additional assistance in caring for medically-complex patients and those seniors needing rehabilitation therapy.
HOME HEALTH: The 15 percent scheduled reduction in payment reductions to home health agencies would be delayed until one year after implementation of the PPS. The plan would also assist agencies with added paperwork and record-keeping costs.
HOSPICE CARE: The conference agreement would increase payments to hospice facilities caring for terminally-ill patients.
TEACHING HOSPITALS: The conference agreement would ensure the vitality of teaching hospitals by maintaining Indirect Medical Education payments and implementing a more equitable structure for Graduate Medical Education payments to teaching hospitals nationwide.
MEDICAL EQUIPMENT: The conference agreement would increase seniors' access to durable medical equipment, such as wheelchairs and oxygen.
FEDERALLY QUALIFIED HEALTH CENTERS: The conference agreement would add provisions to protect clinics from potential reductions in payments in order to maintain access to community health centers.
MEDICAID AND CHILDREN'S HEALTH INSURANCE: The conference agreement would include several provisions to improve the State Children's Health Insurance Program (SCHIP) for low-income children and more stability in SCHIP funding by creating floors and ceilings. In addition, corrections would be made in the original formula to account for under-representation of the population in certain areas. The conference agreement would improve Medicaid disproportionate share (DSH) funding - while most hospitals are limited in how much Medicaid DSH they can receive to 100 percent of their uncompensated care, some are allowed up to 175 percent. The conference agreement would provide a permanent extension for those safety net hospitals. In addition, the conference agreement would allow certain States and the District of Columbia to correct for errors that they made in submitting information for calculating their Medicaid DSH allotments.