Unified industry proposal still in search of a sponsor
By MATTHEW HAY
HHBR Washington Correspondent
WASHINGTON The unified industry proposal for immediate home health payment reforms is still in search of a Congressional sponsor. The five national associations joined forces earlier this year to throw their collective weight behind a single proposal and avoid the internal divisions that plagued the industry’s legislative efforts last year. But that effort has yet to bear fruit.
That proposal would restore access to home healthcare for patients with medically complex conditions and require that a prospective payment system (PPS) is implemented on Oct. 1, 2000, with incentives for agencies to provide services to these patients. It would also eliminate the mandatory 15% cut scheduled for Oct. 1, 2000.
"We are now talking to several Congressional offices seeking a sponsor," said one industry representative. "We don’t have one yet, but I think we will soon," he predicted. The lobbyist said the industry is currently setting up a series of meetings with Capitol Hill offices and hopes to get a member of the House Ways and Means Committee, the Senate Finance Committe, or somebody in a leadership position to sponsor the bill.
Several other measures are also being considered on Capitol Hill. Rep. Edward Markey (D-MA) introduced a long term care proposal last month, but that amendment was defeated in the House Budget Committee. Markey deemed his proposal "the 2% solution" because it would use 2% of future projected budget surpluses to provide long term, in-home, community-based respite care to the elderly.
Markey is now planning on introducing that amendment as a free-standing bill, which will include home health services, nursing care, and respiratory therapy. He has pegged the cost of his proposal at $3.3 billion per year over the next five years. Last month, Markey said that community hospitals in his district had slashed their home health visits from 470,000 in 1997 to 332,000 in 1998 and said that number is expected to fall to 260,000 this year.
"That proposal was defeated in the Budget Committee so now what we have to do is wait for the appropriations process to proceed," said an aide to Markey. "Its political prospects are not as bright as we would like them to be because of the majority’s decision to pass a budget which does not adequately fund home healthcare."
"There are some rumblings about a package of fixes’ to the BBA that is being considered and certainly a big part of that would be specific to home healthcare," another House aide told HHBR. "But I don’t have a sense of what the dollar amount would be."
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