[Congressional Record Volume 146, Number 142 (Wednesday, November 1, 2000)]
[Extensions of Remarks]
[Page E2052]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




 MEDICARE, MEDICAID, AND SCHIP BENEFITS IMPROVEMENT AND PROTECTION ACT 
                                OF 2000

                                 ______
                                 

                          HON. PHILIP M. CRANE

                              of illinois

                    in the house of representatives

                      Wednesday, November 1, 2000

  Mr. CRANE. Mr. Speaker, as we continue to consider the fate of the 
tax bill passed by the House of Representatives last week, I would 
implore the President not to veto this bill. As you know, this package 
includes the Medicare, Medicaid, and SCHIP Benefits Improvement and 
Protection Act of 2000 that provides much needed relief from the 
unintended consequences of the Balanced Budget Act of 1977 to a variety 
of Medicare providers including: hospitals, nursing homes, home health 
agencies, hospice services, and Medicare+Choice.
  Among the various provisions included in the Medicare relief portion 
of this package aimed at improving the quality of care our nation's 
seniors depend on, I would like to call your attention to an important 
public health issues that is in the Medicare relief portion of this 
package. We have all heard from our nation's hospitals about the 
unintended consequences of the Balanced Budget Act of 1997 and it's 
effect on their ability to provide a variety of services to their 
patients. One area that has been hard hit is hospitals' ability to 
treat patients with state-of-the-art blood products. In testimony 
before the Committee on Ways and Means Subcommittee on Health, the 
American Hospital Association specifically cited the costs associated 
with blood as one of the reasons that Congress should restore the full 
market basket index.
  Patient access to a safe and adequate blood supply is a national 
health priority and has been recognized by members of this body, the 
American public, and the nation's public health leaders. Yet, many of 
us have heard from the American Red Cross, America's Blood Centers, and 
the American Association of Blood Banks over the past year about 
hospitals having trouble affording new, innovative blood therapies that 
help to ensure that the nations blood supply is safe for patients. 
Additional funding is needed if we are going to remain commitment to 
providing the safest blood supply possible.
  The blood banking and transfusion medicine communities are constantly 
working to assure that safety improvements for blood are implemented as 
soon as they become available. Two recent initiatives have been 
introduced to increase the safety of the blood supply--Nucleic Acid 
Testing and leukoreduction. Nucleic acid testing allows for early 
detection of infectious diseases (such as HIV and hepatitis C (HCV)) in 
blood by detecting the genetic material of viruses. Leukoreduction, the 
removal of leukocytes (white cells) from blood components can reduce 
the frequency and severity of complications from transfusions. 
Unfortunately these new screening protocols significantly increase the 
cost of blood products. Nucleic Acid Testing and Leukoreduction 
increase the cost of blood products by over 40 percent for both 
hospitals and blood banks.
  Our Nation's nonprofit blood collection centers operate in the same 
managed care environment as our hospitals. While volunteers freely give 
the gift of blood, our nonprofit blood centers must recover the cost 
associated with providing a safe, state-of-the art product. This 
includes the cost associated with collecting, testing processing, 
storing, and distributing blood for patients in need.
  Nonprofit blood centers pass these charges onto hospitals, which, in 
turn, must get timely and adequate reimbursement for these life-saving 
and life-enhancing products. Unfortunately, the current system by which 
the Health Care Financing Administration (HCFA) determined hospital 
inpatient reimbursement rates does not account for these new and 
improved safety measures in a timely manner.
  The Medicare, Medicaid, and SCHIP Benefits Improvement and Protection 
Act directs HCFA and MedPAC to review how hospitals are reimbursed for 
blood and to make the necessary changes to provide for fair and timely 
reimbursement. While those studies will not be complete, nor will the 
recommendations be acted upon during the current fiscal year, we must 
act now to ensure that patients are receiving the safest possible blood 
products.
  The American Hospital Association along with the American Red Cross, 
America's Blood Centers, and the American Association of Blood Banks 
have all recognized the importance of this legislation. By restoring 
the full inflationary update to the Market Basket Index for hospitals, 
Congress is providing the nation's hospitals and blood centers with the 
means to afford new blood therapies and to ensure that patients are 
treated with the safest possible products.

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