[Congressional Record Volume 144, Number 150 (Tuesday, October 20, 1998)]
[Extensions of Remarks]
[Page E2259]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                        REHABILITATION HOSPITALS

                                 ______
                                 

                          HON. JOHN S. TANNER

                              of tennessee

                    in the house of representatives

                       Tuesday, October 20, 1998

  Mr. TANNER. Mr. Speaker, I want to commend the gentleman from 
Massachusetts, Mr. Neal, for taking the lead on an issue that affects 
rehabilitation hospitals and units. It is very important that we work 
with Mr. Neal on this issue to correct some problems that were created 
by the passage of the Balanced Budget Act of 1997 (BBA).
  Mr. Neal's legislation restores incentive payments for PPS-exempt 
rehabilitation hospitals and units that were changed by the BBA. It 
also changes the provision in the BBA which imposed a 15% reduction in 
capital payments for PPS-exempt hospitals and units for FY1998-2002.
  In our efforts to restore Medicare to financial stability last year, 
we may have approved cuts to rehabilitation hospitals and units that 
actually save Medicare dollars. I am afraid that these cuts may 
undermine patient care and force them to either stay in hospitals 
longer or to be discharged home prematurely, or worse, to a nursing 
home.
  Studies confirm that early rehabilitation for stroke and traumatic 
brain injury leads to shorter overall hospitalizations, less mortality 
and fewer complications. This translates to both federal and state, as 
well as private dollars, saved. A few studies have shown that stroke 
patients who receive rehabilitation have better outcomes that those who 
do not.
  These studies also indicate that stroke rehabilitation patients are 
more likely to be discharged to a home than to a nursing home. They 
confirm that comprehensive rehabilitation programs are effective in 
treating low back pain, and that pulmonary rehabilitation reduces 
expensive re-hospitilization and emergency room visits.
  Rehabilitation also maximizes the restoration of functional capacity, 
and it helps people adapt to a more independent life. Rehabilitation 
can help older individuals avoid the services of a nurse or home health 
aide in many cases. All of this translates to savings to Medicare, 
Medicaid and the health care system.
  While we obviously cannot move legislation this year, I am concerned 
about the impact that BBA is having on the payment for providing 
rehabilitation services to Medicare beneficiaries. I am afraid that, in 
our efforts to restore financial stability to the Medicare system, we 
may have implemented a policy which will actually increase Medicare 
spending.
  While I am cautious about suggesting any legislation that may add 
additional costs to the Medicare system, I do not want us to be penny 
wise but pound foolish. I would hope that the Congress can examine this 
issue carefully in the future.

                          ____________________