BBA relief plans unveiled in both House and Senate
BBA relief plans unveiled in both House and Senate
By MATTHEW HAY
HHBR Washington Correspondent
WASHINGTON Legislation introduced in the House and Senate last week could ease the 15% cut in Medicare home health reimbursement slated for Oct. 1, 2000. With time running out in this session of Congress, only the House Commerce Committee has yet to weigh in with a package of reforms to the Balanced Budget Act of 1997 (BBA). But the final plan that emerges from Congress will still have to be reconciled with the more modest proposal set forth by the White House last summer.
House Ways and Means Health Subcommittee Chairman Rep. Bill Thomas (R-CA) unveiled a plan mid-week that would postpone the 15% reduction until six months after the prospective payment system (PPS) goes into effect. After that, the Health Care Financing Administration (Baltimore) would be required to report on the need for any further cuts.
The House plan calls for $9.4 billion worth of congressionally enacted BBA relief and $5.6 billion in Clinton administration-ordered changes over five years. Thomas has been pressing the administration to take actions immediately, but admits he has yet to receive any assurance that will happen.
By contrast, the bill introduced by Senate Finance Committee Chairman Sen. Bill Roth (R-DE) would spread the 15% reduction over three years. The bill calls for a 5% reduction when PPS kicks off, followed by an additional 5% reduction the second year and a final 5% reduction at the beginning of the third year of PPS enactment.
"The House approach is far preferable because it puts it off for another year," said American Federation of Home Care Providers Executive Director Ann Howard. "The way the Senate bill handles the 15% reduction is just not going to work."
The Senate bill would also increase the per-visit limit to 108% of the median, eliminate the consolidated billing requirement for durable medical equipment (DME), and do away with the 15-minute incremental billing requirement.
"Those are three provisions in the Senate bill, but not in the House bill, that we would like to see in a final bill," said Howard. She also backs a repayment provision included in the Senate bill, but said she wants to see the legislative language before she gives it her unqualified support.
The House bill would provide a $10 payment per Medicare beneficiary to offset the costs of OASIS. It also has some good news for suppliers, namely a restoration of the annual consumer price index (CPI) adjustment to Medicare fee schedules for DME. Suppliers would receive adjustments of CPI minus 2% in 2001 and 2002. The bill would also correct an error from the BBA that suspended CPI entirely after 2002. Full CPI adjustments would begin in 2003.
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