MEDICARE HMOs: Bill Aims to Balance Reimbursements

      Responding to the increasing number of HMOs withdrawing from the Medicare+Choice program, Senate Budget Committee Chair Pete Domenici (R-N.M.) and Sen. Ron Wyden (D-Ore.) last week introduced a bill to balance Medicare reimbursements for HMOs in 150 U.S. cities, the Albuquerque Journal reports. The Medicare Geographic Fair Payment Act of 2000 would establish a $525 per patient minimum monthly HMO reimbursement for all counties in metropolitan areas with populations of 250,000 or more. The bill also would raise the minimum reimbursement in rural areas from $415 to $475 in 2001. Dominici noted that HMOs in Albuquerque, N.M., currently receive Medicare reimbursements of $430 per patient each month, compared to the $814 reimbursement received by HMOs in Staten Island, N.Y. Calling the current reimbursement formula nonsensical, Wyden said, "Medicare's bizarre reimbursement system rewards waste and penalizes frugality. It is perverse even by the standards of the Beltway." Estimated at $3.7 billion over the next five years, the bill's cost would be covered by the budget surplus, Domenici said (Coleman, 7/27).