[Congressional Record Volume 144, Number 7 (Thursday, February 5, 1998)]
[Extensions of Remarks]
[Page E109]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                            HOME HEALTH CARE

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                          HON. DEBBIE STABENOW

                              of michigan

                    in the house of representatives

                       Thursday, February 5, 1998

  Ms. STABENOW. Mr. Speaker, I rise today as an advocate for the vital 
services home health care provides to many of our nation's citizens and 
their families--people whose voices are not always heard on Capitol 
Hill. We all recall the stories from the news last year of the bad 
actors who abused the Medicare system and provided inadequate care to 
their patients. Unfortunately, the reprehensible actions of a few home 
health care businesses lead to dramatic changes in the Balanced Budget 
Act that will impact the quality of care of all individuals whose 
doctors and families have decided that home care is the necessary 
course of action. Although it is critical to curb abuse, we must be 
careful that we do not inadvertently cause harm to the small businesses 
who have always provided and who will continue to provide quality care 
to many people in our communities.
  I am very concerned that as of today, home care providers will no 
longer be reimbursed if they visit a patient solely to draw blood. 
Section 4615 of the Balanced Budget Act states that this is a non-vital 
service to provide to homebound patients. What about the blind diabetic 
who needs a blood sugar reading? What about the cancer patient or AIDS 
patient who is confined to a bed and whose continued treatment relies 
on blood tests? This provision of the Balanced Budget Act must be 
reversed or at least modified to allow the needs of the patient to 
determine the need for this health care service. As of today I am a co-
sponsor of the Venipuncture Fairness Act, H.R. 2912, sponsored by my 
colleague, Nick Rahall. H.R. 2912 will reinstate payment under Medicare 
for home health visits made to provide the important service of drawing 
blood. I urge my colleagues to immediately join the Venipuncture 
Fairness Act as co-sponsors and to work to ensure swift passage of the 
bill so that homebound patients do not suffer a life-threatening gap in 
care.
  Other efforts are underway in Congress to reverse decisions made in 
the Balanced Budget Act that inadvertently cause harm to the home care 
providers. This Wednesday I will join Congressman Jim McGovern as an 
original co-sponsor of a bill to protect effective home health care 
agencies from last year's cutbacks. The bill will delay the 
implementation of the interim payment system for home health services 
and provide for a later base year for the purpose of calculating new 
payment rates. It is our hope that the bill will allow continuation of 
quality home health services in communities throughout the country.
  Another obstacle stands in the way of home health care companies 
staying in business. The Balanced Budget Act provisions regarding 
surety bonds is being misread by the Health Care Financing 
Administration. It is reasonable to ask home health care businesses to 
secure a surety bond at an affordable cost. The Balanced Budget Act set 
that cost at $50,000 or 15% of an agency's previous year's Medicare 
revenues. It was assumed that a $50,000 surety bond would be too 
expensive for some agencies, hence the provision for 15% of revenues 
was included to ease the burden on smaller operations. I have now 
discovered that the Health Care Financing Administration is requiring 
all home health care providers to get a surety bond for 15% of the 
previous year's revenues. For some companies, this could be as high as 
half a million dollars, a far cry from the original $50,000 Congress 
intended. I will be circulating a letter to send to the Health Care 
Financing Administration urging them to implement this provision of the 
Balanced Budget Act according to the original intent of Congress. I 
urge my colleagues to sign the letter and send a strong message to the 
Health Care Financing Administration.
  Home health care is a critical part of the health care system for 
thousands of Americans. Citizens, who would otherwise be required to be 
in nursing homes, are able to live independently or with family members 
because of the support services provided by home health care 
professionals. It is critical that our policies make sense for the 
thousands of qualified and dedicated home care agencies in America 
while we focus our energies on those who abuse the system and waste 
taxpayer dollars. I urge my colleagues to join with me in taking 
appropriate actions to meet both important goals. Thank you.

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