[Congressional Record Volume 144, Number 55 (Wednesday, May 6, 1998)]
[House]
[Page H2922]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




     CHANGES IN MEDICARE DECIMATE KANSAS HOME HEALTH CARE PROVIDERS

  The SPEAKER pro tempore. Under a previous order of the House, the 
gentleman from Kansas (Mr. Moran) is recognized for 5 minutes.
  Mr. MORAN of Kansas. Mr. Speaker, I rise this evening to address an 
issue of critical importance to people of Kansas and really the entire 
country. Several provisions buried in last year's Medicare bill are 
decimating home health care providers in Kansas and jeopardizing access 
to critical health care services to the sick and elderly in rural 
America.
  Last year, in the effort to reduce spending, Congress made three 
crippling changes to Medicare reimbursement rates and regulations for 
home health care providers. First, the new interim payment system has 
slashed reimbursements to all agencies and is particularly 
discriminatory to agencies who have historically been the lowest cost, 
most efficient providers.
  Second, the unrealistic requirements that all agencies, regardless of 
size, obtain $50,000 surety bond has been devastating. These bonds are 
expensive for many agencies and generally unavailable in most parts of 
the country. Even the Small Business Administration has acknowledged 
that there are great difficulties that many small agencies are 
experiencing in obtaining these bonds.
  Finally, the loss of venipuncture reimbursement has added to the 
financial difficulties resulting in the closure of many agencies across 
the country, including Kansas. In our efforts to curtail fraud and 
wasteful spending, Congress went too far. Surely Congress did not 
intend to close down reputable and efficient providers of home health 
care services.
  In rural Kansas, health care is not just a quality of life issue. It 
is a matter of survival. A home health care agency in a rural community 
is often the sole provider of services, the critical link between 
hospitals and independent personal recovery. These agencies give 
seniors the opportunity to recover in their own homes with their own 
families and save the Medicare program costly hospital or nursing home 
stays following each illness or injury. Rural providers and their 
patients are especially hurt by cuts in payments due to the high cost 
of providing these services in a rural setting. These cuts threaten to 
leave seniors without adequate care and without independence of home 
care.
  I wholeheartedly support the goal of reforming Medicare. 
Unfortunately, the budget agreement penalized the very efficiency that 
Congress should be encouraging. Last year I was one of only a handful 
of Members to vote against the Medicare budget provisions, not because 
I opposed meaningful reforms in the Medicare program, but because, 
among other reasons, I opposed a payment system which rewarded waste 
and punished efficiency.
  I urge my colleagues in the House to join me in calling for an 
immediate review of the home health care provisions in the Balanced 
Budget Act and to take action necessary to remedy this crisis. 
Yesterday legislation was introduced in the Senate to limit the surety 
bond requirements to new agencies while strengthening protection and 
oversight for fraud, waste and abuse, and legislation has been 
introduced in both Houses to modify the interim payment system and 
provide needed relief for home health care providers.
  Mr. Speaker, these are the real reforms that the Medicare home health 
care program desperately needs. I urge my colleagues to reconsider this 
issue.

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