MEDICARE: Lawmakers Seek Home Health Payment Changes
A bipartisan group of lawmakers -- Reps. Tom Coburn (R-OK), Jim McGovern (D-MS) and Bob Weygand (D-RI) -- Tuesday proposed a plan "to increase financing for home health care agencies." The AP/New York Times reports the lawmakers "are looking for ways to change a 1997 law that sought to wipe out Medicare fraud but that wound up cutting compensation to home health care agencies so much" that it forced many to shut down. "The 1997 budget law did cut fraud, but the fact of the matter is we threw the baby out with the bath water," said Coburn. The congressmen's proposal would change Medicare's present reimbursement system for home health care agencies by "rais[ing] the limit on payments for each visit." The AP/Times reports that the new plan, estimated to cost $1.5 billion over four years, would "give the states block grants for agencies that need extra money to care for chronic, high-cost patients."
In response to federal reports of "rampant fraud and misuse" among home health agencies, Congress last year changed the way the agencies were compensated as part of the balanced budget law. Previously the agencies were paid "virtually without limit" on a "visit-by-visit" basis, but the 1997 law instituted limits on Medicare payments. According to the National Association for Home Care, 752 agencies were forced out of business by the cuts. "These cuts are tearing families apart by forcing the frail and the elderly" prematurely into nursing homes because of a lack of home care providers, said McGovern. The Congressional Budget Office had estimated that the cuts would save Medicare $26 billion over five years; however, more recently the CBO estimated they would save $36 billion over the same period of time. Supporters of the Coburn-McGovern-Weygand proposal "said it was affordable because of the greater-than-expected saving to date," the AP/Times reports (8/6).