House GOP Medicare Reform Package Includes Provision To Eliminate Planned Home Health Payment Cut
A scheduled 15% cut in Medicare payments for home health services would be eliminated but beneficiaries who receive such services would be required to pay a copayment for the first time under a draft of the House Republican Medicare reform package, the AP/South Florida Sun-Sentinel reports. The $350 billion package, which also contains a Medicare prescription drug benefit, will be formally introduced next week. The package includes a provision that would eliminate the 15% cut in home health payments scheduled to take effect in October as part of the 1997 Balanced Budget Act. But the package also includes a provision that would require home health beneficiaries to pay a $50 copay for each "episode" of service, with an episode defined as 60 days of care. Seniors are increasingly obtaining home health services through home health agencies, which provide such services as nursing, attendant care and help with meals (Carter, AP/South Florida Sun-Sentinel, 5/6). Home health care advocates expressed concern about a possible copay. William Dombi, vice president of the National Association for Home Care, said, "We don't want a new tax on people who use our services. Most of the people we serve are poor or nearly poor" (California Healthline, 4/29). The Republican draft also would eliminate a $1,500 annual cap on physical therapy and speech therapy for Medicare beneficiaries. Instead, the package would establish three separate caps of $1,500 for physical, speech and occupational therapy. The package also would boost Medicare payments to rural home health and hospice agencies by 10% (AP/South Florida Sun-Sentinel, 5/6).
As House Republicans prepare to unveil their Medicare reform package, some GOP members are expressing concern about its contents, including the drug benefit, CongressDaily/AM reports. Rep. Charlie Norwood (R-Ga.) expressed concern about plans to reduce payment updates to hospitals by 0.55% a year for an additional four years to institute the home health copays and to include President Bush's prescription drug discount card plan. "We have very serious concerns about the package and are not inclined to support it," a Norwood aide said. Norwood also is concerned that the drug benefit House Republicans are proposing would not provide assistance to moderate-income seniors (Fulton, CongressDaily/AM, 5/7). Under the GOP measure, Medicare beneficiaries would receive coverage for 70% to 80% of the first $1,000 of their annual prescription drug costs and coverage for 50% of their annual costs between $1,000 and $2,250. Seniors would have to cover 100% of their annual prescription drug costs between $2,250 and $5,000, but the legislation would cover 100% of annual costs of more than $5,000. The bill also would cover all drug costs for beneficiaries with annual incomes less than 135% of the federal poverty level, and seniors with annual incomes slightly more than that level would receive aid on a sliding scale (California Healthline, 5/6). Some members of both parties also are expressing concern about the cost of the benefit. The GOP package was crafted by House Ways and Means Committee Chair Bill Thomas (R-Calif.) and House Energy and Commerce Committee Chair Billy Tauzin (R-La.) (Fulton, CongressDaily/AM, 5/7).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.