What's hot in reimbursement?
April 1, 1997 2 minutes read
What’s hot in reimbursement?
If you’re looking for more federal funds in the coming year, you had better look at boosting your pediatric services. Experts estimate that 10 million children in the United States have no insurance coverage, and President Clinton’s five-year plan would throw a safety net over half that number a group called "gap children," because they fall through the gaps of new Medicaid policies. Here’s how Clinton would toss the net:
• Children would be allowed to stay on Medicaid rolls for a year at a time, rather than having to re-certify every six months, as they are now required to do.
• An outreach program would make a proactive effort to bring in children who now qualify under existing Medicaid regulations but who are not enrolled.
• An allocation of $750 million would be given to states to enable them to work with insurers, health providers, businesses, and schools to expand coverage for another one million children.
• Implementation of a provision in the new Medicaid law that reaches out to adolescents ages 13 through 18 would expand the coverage they already receive another one million children.
Other lawmakers have proposals, as well. Here are two of them:
• Health care vouchers funded by cigarette tax. Sen. Edward Kennedy (D-MA) is sponsoring a bill that would provide vouchers to help cover children in families with incomes from 185% to 300% of the federal poverty level. Kennedy’s bill would levy a cigarette tax to fund the coverage.
• Insurance provided by earmarked tax credit. Senate Minority Leader Tom Daschle (D-SD) is sponsoring a bill that would offer refundable tax credits to help families purchase private insurance coverage for children. The credit would then be pro-rated as a family’s earnings increase. While Clinton touted insurance for children during his State of the Union address, the American Academy of Pediatrics in Chicago has worked in the trenches for the past several year, trying to put the issue in the spotlight.
Another potentially hot area is prevention. While it often gets lip service as a key to cost savings, reimbursement for preventive measures often falls short. Clinton is offering a laundry list of preventive care services that he says Medicare should cover, including annual mammograms, pneumonia vaccines, colorectal screening, and diabetes screening.
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