[Congressional Record Volume 144, Number 143 (Sunday, October 11, 1998)]
[Extensions of Remarks]
[Page E2081]
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. ROBERT A. WEYGAND

                            of rhode island

                    in the house of representatives

                        Friday, October 9, 1998

  Mr. WEYGAND. Mr. Speaker, I rise this morning to express my support 
for this legislation which provides some measure of relief to certain 
home health care agencies in my state. I want to thank my colleagues, 
Mr. McGovern,1 Mr. Coburn, Mr. Cardin, Mr. Stark and others who have 
worked hard on this issue with me since last year.
  Last May, I sponsored an amendment to the Budget Resolution which was 
the first legislative action taken on IPS reform during the 105th 
Congress. This amendment, which passed unanimously, was significant 
because it called upon this Congress to take active steps to restore 
fairness and equity to the IPS. It called upon Congress to examine the 
effects of the IPS on low cost agencies and stressed the importance of 
accomplishing reform before the 105th Congress adjourned. I am pleased 
that Congress has addressed this issue and hope we can pass something 
which will be signed by the president soon.
  Although this legislation before us today does not provide the amount 
of financial assistance that I believe is necessary, I believe it 
represents a first step to restoring some of the unfair and inequitable 
cuts enacted by the Balanced Budget Act.
  The home health care provisions within this bill will help some home 
health care agencies, particularly those in my home state operating 
below the national average. By providing fifty-percent of the 
difference between an agency's current per beneficiary limit and the 
national average, Medicare will provide some additional reimbursement 
to many agencies in my state.
  The legislation also permits home health care agencies operating 
above the national average to continue receiving the reimbursement they 
currently receive. Although some of these high cost agencies may be 
deserving of higher reimbursement, I have concerns that this payment 
policy continues to provide rewards to home health care agencies which 
were not frugal prior to the passage of the Balanced Budget Act, and 
effectively continues to penalize agencies which worked tirelessly to 
contain their costs. This is due, in part, to the large reliance to 
agency-specific data, as mandated by the Balanced Budget Act. I had 
wished that the resolution to this issue would have better addressed 
this situation and created a more level playing field, and home that 
with ongoing communications with the Senate and the Administration, we 
can work to further refine this measure to restore more equity into the 
home health care system.
  I am disappointed that this legislation does not provide relief 
retroactively to home health care agencies. As you are aware, the 
Balanced Budget Act subjected home health care agencies to per 
beneficiary limits for cost reporting periods beginning on or after 
October 1, 1997. Some home health care agencies throughout the nation 
have been operating with low per beneficiary limits during their 
current cost reporting periods and need assistance now. While this 
legislation will provide much needed relief to some home health care 
agencies for cost reporting periods beginning during or after fiscal 
year 1999, it will not provide immediate relief to many deserving home 
health care agencies.
  While I am pleased we have reached this point and will support this 
bill, there remains a great deal to be done. With the passage of the 
Balanced Budget Act, Congress mandated an additional fifteen percent 
cut in home health care if the new payment system is not fully 
implemented. The administration signaled in August that the new system 
will not be ready before October 1, 1999 so the cut remains a real 
threat to home health care agencies in the very near future. We need to 
address this issue and I look forward to working with my colleagues to 
delay or repeal this 15% cut next year.
  I want to express my appreciation to the Committees on Ways and Means 
and Commerce for recognizing the situation home health care agencies 
and their Medicare beneficiaries face. Home health care is an important 
service that we must work our hardest to preserve. Home health care 
allows seniors to remain home and retain their dignity and 
independence. While this legislation does not accomplish all I had 
wanted, I support its efforts, applaud its goal and urge my colleagues 
to support it.

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