Home Health & Hospice Week

The Medicare program has made a narrow escape from huge budget cuts proposed by Republican leadership in the House of Representatives.

In its 2004 budget resolution, which is the blueprint for final budget negotiations later in the session, Republican lawmakers at first proposed more than $200 billion in cuts to Medicare spending and more than $110 billion in cuts to Medicaid spending. They also proposed a $400 billion prescription drug benefit.

After outcry from legislators including moderate Republicans, leadership revised the resolution to eliminate the Medicare cuts. But the Medicaid cuts stayed in place and passed in the March 20 vote approving the measure 215 to 212.

Observers predict the Senate resolution won't include the Medicaid cuts, and they'll be dropped in negotiations between the two chambers.

Sen. Susan Collins (R-ME) is pushing for home health agencies to receive reimbursement relief in the Senate. Collins has introduced a "Sense of the Senate" amendment to the budget resolution to stabilize home care reimbursement, says the National Association for Home Care and Hospice.

Collins also has introduced a bill (S. 636) that would extend the 10 percent rural add-on past its April 1 expiration date.

Meanwhile, the House Ways and Means Health Subcommittee March 20 passed Medicare regulatory and appeals reform legislation addressing a multitude of problems. Among other things, the legislation would ensure that new regulations aren't applied retroactively and would prohibit recovery of overpayments if providers follow erroneous written guidance from Medicare reps.

One controversial measure in the law, the move to place administrative law judges in the Department of Health and Human Services instead of their current place in the Social Security Administration, was tempered by language added in the markup session. The changes would require that although ALJs would move to HHS, they would not be incorporated into the Centers for Medicare & Medicaid Services. Legislators have protested that it will compromise the independence of the ALJs' appeals reviews if they are under the jurisdiction of the department that makes the original claims determinations.