Industry has high hopes for two new major home care bills

HHBR Washington Correspondent

WASHINGTON – Signs are improving that some of the funding that the Balanced Budget Act of 1997 (BBA) stripped from the Medicare home health benefit will be restored this year. But with Congress about to adjourn for its Fourth of July recess, there is still no clear indication how this process will unfold.

"There is a growing recognition that the BBA went too far," said Eric Sokol of the National Association for Home Care (Washington). Two bills expected to be introduced shortly in the Senate reflect that view. Both bills – one being drafted by Sen. Jim Jeffords (R-VT) and the other expected to be co-sponsored by Sens. Susan Collins (R-VT) and Kit Bond (R-MO) – would repeal the additional 15% cut scheduled for Oct. 1, 2000, and increase payments under the interim payment system for agencies with high-cost, medically complex patients. The Collins/Bond bill would also increase per-visit and per-beneficiary limits.

But "it is still tough to see how this will come together," warns a senior House Ways and Means Health Subcommittee staffer. "There are all these ideas floating around, but nobody knows what legislation they will be attached to. Nobody has put the Jell-O in the pot this year."

Meanwhile, President Clinton is expected to introduce his Medicare proposal tomorrow. According to administration officials, the proposal will be a soup-to-nuts plan with a number of enticements for seniors, including a prescription drug benefit and added protections for low-income seniors. But it is also expected to include a co-pay for Medicare home health services (possibly capped at a certain income level). Most observers believe a prescription drug benefit will be passed in some form this year and that the co-pay for home health will be offered as an offset.