Here's a guide to pending legislation
August 1, 1998 5 minutes read
Here's a guide to pending legislation
The National Association for Home Care (NAHC) in Washington, DC, is asking Congress to pass bills that would repeal the Medicare venipuncture change and change the interim payment system (IPS) requirements.
The NAHC describes pending legislation as follows:
· HR 2912, the "Medicare Venipuncture Fairness Act." Introduced by Rep. Nick Rahall (D-WV), this bill would repeal the current restriction on venipuncture and require a study to examine the appropriate use of the venipuncture benefit. The bill has 100 co-sponsors.
· HR 3137, the "Medicare Venipuncture Seniors Protection Act of 1998." Introduced by Rep. Robert Aderholt (R-AL), this bill would delay implementation of the restriction on venipuncture until Aug. 5, 1999, and it calls for a study to examine the Medicare venipuncture home health benefit. The bill has 41 co-sponsors.
· SB 1580, the "Medicare Venipuncture Assessment Act of 1998." Introduced by Sen. Richard Shelby (R-AL), this bill would delay implementation of the restriction on venipuncture until Aug. 5, 1999, and it calls for a study to examine the Medicare venipuncture home health benefit. This is a companion bill to HR 3137. It has 17 co-sponsors.
· HR 3162. Introduced by Rep. Wes Watkins (R-OK), this bill would delay the implementation of the IPS until Oct. 1, 1998. The bill has 13 co-sponsors.
· HR 3108. Introduced by Rep. Jim Saxton (R-NJ), this bill would alter the calculation of payment under the IPS by changing the base year from fiscal year 1994 to calendar year 1994. Also, the bill would not freeze costs from 1994 to 1995, as mandated by the Balanced Budget Act of 1997. The bill has three co-sponsors.
· HR 3651, "Medicare Home Health Agency Act of 1998." Introduced by Rep. Eliot Engel (D-NY), this bill would make a number of changes to the IPS, including these:
- modify the per-visit cost limits to 110% of the mean in fiscal year 1998, then 107% thereafter;
- modify the annual per-beneficiary cost limits to a blended rate based on 75% of the national average costs per beneficiary for cost reporting year 1995, and 25% on the average cost per beneficiary in the state in which the agency is located for cost reporting year 1995;
- establish an "efficiency standard" and limit future reductions in the Medicare home health benefit to the amount needed to achieve the original savings set by the Congressional Budget Office at the time the Balanced Budget Act was enacted.
The bill has 24 co-sponsors.
· HR 3205. Introduced by Rep. James McGovern (D-MA) and Rep. Merrill Cook (R-UT), this bill calls for a delay in the IPS until Oct. 1, 1998. It also would change the base year for IPS calculation to fiscal year 1995 or, at the election of the home health provider, calendar year 1995. The bill has 59 co-sponsors.
· SB 1643. Introduced by Sen. Edward Kennedy (D-MA) as a Senate companion bill to HR 3205, it has the same provisions as HR 3205. The bill has seven co-sponsors.
· HR 3567, "Medicare Home Health Equity Act of 1998." Introduced by Rep. Mike Pappas (R-NJ), this bill would make a number of revisions to the IPS, including the following:
- change the calculation of the per-beneficiary limit to 75% of national average costs per patient in fiscal year 1994 and 25% of regional average costs per patient in fiscal year 1995, with an additional payment for outliers;
- restore the per-visit cost limits to 112% of the mean.
The bill has 81 co-sponsors.
· SB 1993, "Medicare Home Health Equity Act of 1998." Introduced by Sen. Susan Collins (R-ME), this bill would do the following:
- restore the formula for calculating the per-visit cost limits to 112% of the mean, rather than 105% of the median;
- amend the method for calculating the aggregate annual per-beneficiary limit under the IPS to a blend of 75% of national average cost per patient and 25% of regional average cost per patient;
- include an outlier provision similar to the one implemented during the phase-in of the hospital prospective payment system.
The bill is the Senate companion to HR 3567. It has 20 co-sponsors.
NAHC speaks out
William A. Dombi, vice president for law and director of the Center for Health Care Law at NAHC, testified before a U.S. Senate Special Committee on Aging on March 31. He made these recommendations for changes to the IPS:
· Congress should delay the implementation of the per-beneficiary limits until fiscal year 1999.
· Congress should change the base year from 12-month cost reports ending fiscal year 1994 to 12-month cost reports ending calendar year 1995. In addition, Congress should change the per- beneficiary limit calculation in the IPS from 98% to 100% of the base year cost per patient.
· Congress should change the mandatory Oct. 1, 1999, 15% reduction in the limits to a reduction of up to 15% based on the targeted expenditures for home health during that year.
· Congress should allow the full market basket increase in calculating the per-beneficiary limits, instead of the current system of basing the limits on 105% of median per-visit costs that do not take into account the market basket price increases that occurred between July 1, 1994, and June 30, 1996.
· Congress should require HCFA to use the prorating provision only in situations where agencies are transferring or prematurely discharging patients for purposes of intentionally circumventing the limits.
· Congress should extend authorizations for exemptions and exceptions to the per-beneficiary limits.
· Congress should assign new providers a per-beneficiary limit that is the median of the limits for the census division where the agency is located.
· Congress should, at a minimum, maintain periodic interim payments until a prospective payment system is enacted.
[Editor's note: For more information about the pending legislation, you may contact NAHC at (202) 547-7424 or visit NAHC's Web site at http://www nahc.org.]
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