[Congressional Record Volume 144, Number 143 (Sunday, October 11, 1998)]
[Extensions of Remarks]
[Page E2076]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




 MEDICARE HOME HEALTH AND VETERANS HEALTH CARE IMPROVEMENT ACT OF 1998

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                               speech of

                            HON. JOE BARTON

                                of texas

                    in the house of representatives

                        Friday, October 9, 1998

  Mr. BARTON of Texas. Mr. Speaker, I would like to express my support 
for legislation passed by the House of Representatives on October 9, 
1998, H.R. 4567, ``The Medicare Home Health Care Interim Payment System 
Refinement Act,'' as it was amended by the Commerce Committee. This 
legislation will remedy some of the problems the home health agencies 
in my state and district are facing with the interim payment system 
passed in the Balanced Budget Act of 1997.
  The state of Texas is a unique state in more ways than one. We have a 
very large and ever-growing population. We also have a very high number 
of ``new'' home health agencies, meaning agencies established after 
October 1, 1994. According to the September 1998 General Accounting 
Office report to Congress on Home Health Agency Closures, Medicare-
certified home health agencies in Texas grew from 961 agencies in 1994 
to 1,949 agencies in 1997. According to that same report, 134 agencies 
have closed recently, leaving the state with 1,758 agencies as of 
August 1, 1998, still more, many more agencies than existed in the 
state in 1994. As you can see, Texas, as opposed to a state like New 
Hampshire which has only 46 home health agencies, has been affected 
greatly by the interim payment system.
  One issue I have been very involved with as the Chairman of the House 
Commerce Subcommittee on Oversight and Investigations is the problem of 
fraud and abuse in the Medicare and its effect on the continued 
solvency of the program. One of the changes made in the Balanced Budget 
Act of 1997 was to move Medicare home health care reimbursement to a 
prospective payment system (PPS). Since there were impediments to going 
to a PPS immediately, an interim payment system (IPS) was established 
for reimbursement to home health care agencies. As stated above, the 
IPS has caused problems for many agencies, especially newer agencies. 
The problems with the IPS and the fact that HCFA recently announced 
that they will not meet the original October 1, 1999 date set for the 
PPS to be enacted required Congressional action to straighten out some 
of the problems with the IPS.
  There are obviously some bad actors in home health care, but there 
are many more good ones. I do not believe it was the Congress' 
intention for good operators to be punished by regulations that are too 
punitive. The honest providers who want to provide quality care should 
not be penalized.
  The legislation considered by the House makes a move in the right 
direction. I commend the principals involved, Ways and Means Chairman 
Bill Archer and Health Subcommittee Chairman Bill Thomas, as well as 
Commerce Chairman Tom Bliley and Health Subcommittee Chairman Michael 
Bilirakis, on achieving some legislative relief for the home health 
agencies in my state as well as across the country.
  I do not believe that I am alone in the sentiment that we will be 
revisiting the home health care issue in the 106th Congress for there 
are additional issues yet to be considered. I do support this home 
health package and its contribution towards a workable, efficient, and 
common sense solution for home health care agencies across this 
country.

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