MEDICARE GIVEBACKS: House Panel Approves $21B Plan
Hoping to quell the HMO exodus from the Medicare+Choice program, the House Commerce Committee approved a five-year, $21 billion bill to boost payments to Medicare and Medicaid providers -- with managed care plans among the "biggest recipients," the Wall Street Journal reports. The legislation would increase HMO reimbursements in certain geographical areas and provide HMOs with $4.8 billion over five years. HMOs would net an additional $1.2 billion because increased payments to fee-for-service Medicare benefits also would "trickle down" to them. While government studies claim that managed care firms already receive more than adequate compensation, many HMOs have abandoned the Medicare+Choice program over the past three years because of low reimbursement rates, leaving about 1.7 million seniors without supplemental coverage. According to Karen Ignagni, president of the American Association of Health Plans, the proposed $6 billion increase "falls far short ... [i]f the objective is to save the program" (Murray, Wall Street Journal, 9/27). "[Congress] has to decide if it's going to rescue this (Medicare+Choice) program, and if it's going to rescue the program, the number has to be higher," Ignagni said, although she admitted, "[It's] a good first step" (Rovner, CongressDaily/A.M., 9/27). White House officials and congressional Democrats worry that the additional funding will not guarantee better services or higher enrollment. "Payments to HMOs without accountability provisions do not guarantee that the plans will stay [in Medicare], or that benefits will be maintained," White House health care adviser Chris Jennings said. The bill also would provide funding for new Medicare treatments and services; allow states to begin offering Medicaid coverage to some legal aliens; and redistribute 40% of the $1.9 billion in unclaimed CHIP money.
Archer Means Business
Meanwhile, the House Ways and Means Committee, which shares jurisdiction over Medicare, will likely mark up the bill Thursday to provide more money for inpatient hospital care, skilled nursing facilities and home health care agencies (Wall Street Journal, 9/27). CongressDaily/A.M. reports that the Commerce Committee's move puts the Ways and Means Committee "in a difficult position" since it spent all of the $21 billion previously set as a limit without leaving money for hospitals and nursing homes -- which come under the jurisdiction of Ways and Means. The Ways and Means Committee had not planned on a formal markup, but committee Chair Bill Archer (R-Texas) said, "Clearly, [the Commerce proposal] can't stand. There's too much demand for upgrading reimbursement to hospitals and nursing homes." Still, Archer said a formal markup session may or may not take place. "I don't know," he said, adding, "There are always many options in a democratic legislative body for how you address problems" (CongressDaily/A.M., 9/27).