[Congressional Record Volume 144, Number 26 (Thursday, March 12, 1998)]
[House]
[Page H1145]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                            HOME HEALTH CARE

  The SPEAKER pro tempore. Under a previous order of the House, the 
gentleman from Michigan (Mr. Barcia) is recognized for 5 minutes.
  Mr. BARCIA. Mr. Speaker, I want to talk about an issue that I am very 
concerned about today and that affects the quality of health care 
throughout this great Nation.
  A few years ago, back in about 1989, I was involved in an automobile 
collision in which two, my car and another car, collided. The other car 
crossed the center line, and we had a horrendous crash. And I ended up 
serving about 4 weeks, receiving acute care in my hometown of Bay City, 
Michigan.
  After I was released from the hospital, I had the privilege of being 
able to be a recipient of home health care. During that time, I was in 
a wheelchair and also on crutches for about 12 weeks.
  So I got a massive dose, I guess, of education in terms of what the 
patients of this country go through in terms of receiving that quality 
health care in an acute facility, but then also having the opportunity 
to be released from that facility to recuperate further in a home 
environment.
  Mr. Speaker, anyone who has ever had the need for extended medical 
care, as I have, knows that the ability to recuperate in one's own home 
provides a reassurance that cannot be provided in any other medical 
facility.
  The people in our Nation that provide home health care provide a 
vital and cost-effective form of health care and medical treatments. 
Certainly when we have this quality care, we need to do all that we can 
to preserve our current home health care system.
  That home health care system is, in fact, threatened by part of the 
recent balanced budget agreement that we voted on here in this House. 
As part of the Balanced Budget Act of 1997, we required that home 
health care providers obtain surety bonds in order to be a Medicare or 
Medicaid-eligible provider. The intent was to be sure that we could 
guard against fraud in the program, and no one would certainly disagree 
with that very worthy goal.
  However, obtaining bonds can work a financial hardship on providers 
who are faced with extremely tight cash flows, especially since the 
Health Care Financing Administration wants to treat the cost of 
obtaining a bond as a nonreimbursable expense.
  Fortunately, there is an alternative available. There is a long-
standing provision of the U.S. Code which allows for government 
obligations like savings bonds and Treasury bills to be used as a 
substitute for surety bonds when surety bonds are required.
  HCFA, to its credit, has recognized this option, and just this week 
met with officials of the Treasury Department to determine if 
government obligations could substitute for surety bonds in this 
instance.
  I am happy to report to our colleagues that officials of both the 
Treasury Department and HCFA have advised my office that this 
substitution should be an option in the case of Medicare providers, and 
that they are hopeful in making it applicable in the case of Medicaid 
providers as well.
  There are some details that need to be resolved by HCFA's counsel 
prior to a final decision being made, but I am hopeful that, in the 
end, we will be able to achieve meaningful assurance for our Medicare 
and Medicaid programs, not unfairly limit people's choices of care 
providers, and minimize any cost consequences to care providers.
  I am hopeful that in HCFA's final determination that the agency will 
accept the face value of the government obligation as the par value, 
and not require an absolute current dollar-to-dollar match. The 
obligations, in my view, are sufficient to protect the government's 
interest and the integrity of the program.
  Mr. Speaker, I urge all of our colleagues and home health care 
providers across the country to join me in urging HCFA to, as soon as 
possible, approve the use of government obligations in lieu of surety 
bonds, using the face balance as par value in this very important 
program.

                          ____________________