House puts several home health issues in the spotlight
By MATTHEW HAY
HHBR Washington Correspondent
It was a busy week for home healthcare on Capitol Hill last week. As Congress broke for Fourth of July recess, two more home care bills were introduced in the House, and a coalition of members announced the formation of a working group to press for changes in the Balanced Budget Act of 1997 (BBA).
On June 30, nearly 60 members of the House announced the formation of the Home Health Working Group as part of the Rural Health Care Coalition to raise the visibility of the problems in home care brought about by the BBA and the Health Care Financing Administration’s (HCFA; Baltimore) implementation of those provisions. Reps. John Peterson (R-PA) and Earl Hilliard (D-AL), who co-chair the group, were among roughly a dozen House members who gathered to announce the formation of the working group at a press conference at the U.S. Capitol. "Basically the focus of this working group is to look at everything and see if we can’t be in the mix when these problems are addressed later this year," said an aide to Peterson.
Home care representatives were encouraged by the cross-section of House members included in the coalition and present at the press conference. They ranged from Independent Bernie Sanders from Vermont, to conservative J.C. Watts from Oklahoma, who heads up the Republican caucus.
Also last week, Reps. Pete Stark (D-CA) and Karen Thurman (D-FL) introduced legislation that would make sweeping changes to the surety bond requirements for home health agencies and durable medical equipment (DME) suppliers. Stark, the ranking Democrat on the House Ways and Means Committee Health Subcommittee, was instrumental in drafting the original surety bond provision included in the BBA, but objected to HCFA’s implementation of that provision.
HCFA officials revealed last week that it will not issue revised regulations for the surety bond requirement until Oct 1, 2000. The controversial requirement was put on hold last year pending a General Accounting Office (Washington) study that was completed earlier this year.
Stark’s bill, the Medicare and Medicaid Surety Bond Reform Act of 1999, would cap the amount of the surety bond at $50,000 and limit the requirement to home health and DME providers in the first two years of participation in the Medicare and Medicaid programs. It would also allow one bond to satisfy both the Medicare and Medicaid surety bond provisions.
In addition, Rep. Bernard Sanders (I-VT) introduced the Medicare Home Health Restoration Act on June 24, which basically amounts to a wish-list for the home care industry. Sanders’ bill would roll back the interim payment system (IPS) entirely. "It would basically repeal the IPS altogether and make retroactive payments to home health agencies," said an aide to Sanders. The bill would also repeal both the temporary 15% across-the-board cut scheduled for October 2000 as well as the permanent 15% across-the-board cut.
In addition, Sanders’ bill would extend the Periodic Interim Payment Program (PIP), which is set to be eliminated for portions of cost reporting periods occurring on or after Oct. 1, 2000, and restore the per-visit cost limits to 112% of the mean rather than the 106% of the median in the BBA.
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