Groups Lobbying for and against $43 Billion Senate Medicare ‘Giveback’ Package

Health care groups with an interest in the Medicare provider "giveback" bill introduced yesterday by Sens. Max Baucus (D-Mont.) and Charles Grassley (R-Iowa) are "speaking up" about the package, CongressDaily/AM reports (Fulton, CongressDaily/AM, 10/3). The 10-year, $43 billion package includes "smaller-than-planned" cuts for hospitals and increases in payments for rural physicians, hospitals and home health agencies. Medicare+Choice plans would receive a boost in payments of 4% in 2003 and 3% in 2004. The bill also would reverse the expiration of $1.7 billion in temporary Medicare funding for nursing homes that expired Oct. 1. In addition, the package would expand a pilot program that uses competitive bidding for durable medical equipment nationwide. The plan also includes a provision that would allow Medicare to cover immunosuppressive drugs for organ transplants and would renew a five-year program that helps low-income seniors pay their Medicare premiums. The plan includes a two-year delay of payment caps for physical and occupational therapy and would expand coverage of cholesterol and lipid level tests. The package also includes additional funding for state Medicaid and CHIP programs (California Healthline, 10/2). While it is unclear when the Senate will take action on the package, which was introduced directly to the floor, the American Hospital Association is "urging" lawmakers to support the bill. In a letter sent to senators yesterday, AHA said, "We believe this legislation will take another step forward in addressing the unintended consequences of the Balanced Budget Act [which mandated the cuts the giveback bill would reverse] as well as improve payments for rural hospitals."

While home health care agencies support language in the bill that repeals a 15% cut in payments that took effect Oct. 1, the American Association for Homecare is opposing the competitive bidding for durable medical equipment provision. The organization, along with the Coalition for Access to Medical Services, Equipment and Technology, said preliminary data from two HHS pilot programs on competitive bidding "are not in, and it would be too soon to conclude" if the programs are successful. According to the groups, basing policy on incomplete data from the studies would "threaten quality of care and patient choice," CongressDaily/AM reports. John Kemp, chair of the American Association of People with Disabilities, a CAMSET member, said, "We have serious concerns with proceeding with a national competitive bidding program, when important questions about access, quality and choice of provider have not been fully answered" (CongressDaily/AM, 10/3).