MEDPAC: To Recommend ‘Wait and See’ Approach to Payments
The Medicare Payment Advisory Commission will recommend that changes in reimbursements to hospitals and managed care plans be delayed until the full effects of the 1997 Balanced Budget Act are known, CongressDaily reports. Providers and health plans have pushed for increased payments, as a rash of Medicare HMO withdrawals and increasing hospital red ink followed the controversial legislation. MedPAC Chair Gail Wilensky said the commission opposes the president's proposed Medicare hospital rate freeze, and will also recommend pushing back the May 1 deadline for health plans to submit their Medicare HMO coverage proposals, saying the requirement is an "unreasonable request." HCFA has recommended extending the deadline until July 1, but that would require a legislative fix. Other recommendations in the report to be released Monday include a $5-per-visit copay for Medicare home health visits -- likely to be a controversial proposal, despite the exemption for those earning less than 120% of the federal poverty level -- and support for HCFA's proposal of a risk-adjusted payment schedule for HMOs (Rovner, 2/25).
CNA Health Partners' Kirk Johnson, testifying on behalf of the Health Insurance Association of American, blasted the proposed risk-adjustment scheme, charging it would decrease total payments to Medicare HMOs by about $200 million in 2000. In testimony before the House Commerce Committee's subcommittee on health and the environment, Johnson also called for increases in Medicare HMO reimbursements to be linked with local medical inflation rates, and criticized "overly rigid" and "one-size-fits-all" HCFA quality standards and oversight (HIAA release, 2/25). Wilensky will testify Tuesday on the MedPAC recommendations before the House Ways and Means' subcommittee on Health (subcommittee release, 2/25).