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Bill Raises Medicare Payments  LIST.HEALTHPLAN
 Nov 05, 1999 21:30 PST 
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A bill that would restore billions of dollars previously trimmed from
Medicare payments to hospitals, nursing homes and other caregivers was
approved 388-25 by the U.S. House of Representatives Friday, November 5,

The legislation provides $11.5 billion over five years.

Political divisions have scuttled chances for agreement on other
Medicare changes this year, including adding new prescription drug
benefits for senior citizens.

Most of the money in the House bill would go to hospitals, especially
teaching hospitals, those located in rural areas, and those that care
for large numbers of uninsured patients. Nursing homes and home health
care companies also would get a boost in their fees.

HMOs, which have quit serving Medicare beneficiaries in many counties
during the past two years, would get bigger payments and additional cash
bonuses if they venture back into unserved areas.

Among changes that would affect Medicare beneficiaries most directly:

* A cap that has limited coverage for speech and physical therapy a
combination often needed by people recovering from a stroke to a total
of $1,500 a year would be raised to $1,500 for each type of therapy.

* Co-payments for hospital outpatient care, which currently vary widely
and often exceed Medicare's standard 20 percent co-pay, would be limited
to the same amount as the deductible for inpatient care, $776 in 2000.

* Retirees who lose their HMOs would have more flexibility to enroll in
other ones or buy Medigap insurance.

* Medicare payments for pap smears would rise to ensure access to the
latest technology.

Additionally, the bill would provide more money for Puerto Rico and U.S.
territories to participate in a new children's health insurance program
that Congress created in 1997.

Some differences still must be resolved between the House bill,
legislation pending in the Senate and the Clinton administration.
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