MEDICARE: Advisory Panel Recommends Home Care Copayment

      The Medicare Payment Advisory Commission, "a permanent board of private-sector experts who evaluate Medicare policies and make suggestions to Congress," has recommended that Congress require "modest copayments" for home health care visits to the elderly. The AP/Los Angeles Times reports that the commission recommended that Medicare charge "a small copayment" but did not specify an exact fee, and recommended that the copayment "be subject to a cap on the maximum amount senior citizens could be charged out of pocket each year." Additionally, the board recommended that Medicare "assign independent case managers to review" extended home care situations in order to "ensure the appropriateness of that care." The panel was also critical of Congress' neglect of those "senior citizens paying out of their own pockets an average of 50% of Medicare's bills from hospital-run clinics for common outpatient services such as rehabilitation, one-day surgery, radiology and testing." Technically, seniors are limited to "20% of the cost of covered services" in Medicare. Under last year's Balanced Budget Act, the discrepancy will be adjusted gradually over 20 years, but the commission said that adjustment should happen over a "significantly shorter" period.

Time To Change
      Commission Chair Gail Wilensky said the changes were necessary to rein in the skyrocketing costs of Medicare home health benefits. She said, "We don't want to deprive people who need services. Our concerns were to try to balance the ... explosive growth in spending" (Love, 3/3).