[Congressional Record Volume 144, Number 106 (Friday, July 31, 1998)]
[Senate]
[Page S9609]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




        MEDICARE HOME HEALTH BENEFICIARY PROTECTION ACT OF 1998

 Mr. FRIST. Mr. President, I rise today to add my name as a 
cosponsor to S. 2354, the ``Medicare Home Health Beneficiary Act of 
1998''.
  This bill amends title XVIII of the Social Security Act to impose a 
moratorium on the implementation of the Interim Payment System (IPS) 
for home health agencies. This IPS was set up by Congress at the 
recommendation of the Health Care Financing Administration (HCFA) as a 
transition to a Prospective Payment System. However, the IPS, along 
with surety bond requirements and other regulatory implementations of 
the Balanced Budget Act, has had a negative influence on the home 
health care providers and their patients, forcing many providers out of 
business.
  The IPS has hurt home health care in Tennessee. For example, in 
Tennessee, the amount of funding each agency receives per patient per 
year was based on each agency's costs for Fiscal Year 1994. This method 
of calculation has the potential to penalize agencies who acted 
responsibly to hold down costs. One Tennessee provider, who had very 
low 1994 costs due to aggressive cost control, is concerned that the 
IPS may force them out of business. We cannot afford to sacrifice 
quality in home health care, and we must not punish agencies that have 
always tried to provide quality care at reasonable costs.
  In addition, some home health providers who have a good reputation in 
their communities, built on years of service, did not submit a full 
cost report for Fiscal Year 1994 due to accounting methods. 
Regrettably, these agencies are now classified by HCFA as ``new 
agencies.'' If the agency is classified as a new agency, then their 
historic costs are disregarded in their reimbursement, and they will 
receive a payment based on a national average. Well, Mr. President, we 
know that the cost of care in Tennessee may be very different from the 
cost of care in another region. In fact, in Tennessee, home health 
costs tend to be higher than the national average. This will make it 
extremely difficult for these agencies to meet the IPS budget 
constraint.
  Home health care provides a critical service to our nation's Medicare 
beneficiaries. The IPS was created to address some of the problems with 
cost control in the home health industry. However, it appears that this 
interim plan manages to create more problems than it solves. In fact, I 
believe it can do more harm than good. We need to impose a moratorium 
on IPS and encourage implementation of a system of fair reimbursement 
payment rates that ensures all home health providers are cost-effective 
without sacrificing quality of care for patients. We must find a way to 
terminate those agencies that take advantage of seniors and the 
Medicare system, while ensuring continuity of high quality home health 
care for our nation's most vulnerable populations.

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