[Congressional Record Volume 147, Number 126 (Tuesday, September 25, 2001)]
[House]
[Pages H6046-H6047]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
INTRODUCING H.R. 2953, LEGISLATION TO EXTEND SOCIAL HEALTH MAINTENANCE
ORGANIZATIONS AND MAKE THEM PART OF MEDICARE+CHOICE PLANS PERMANENTLY
The SPEAKER pro tempore. Under a previous order of the House, the
gentleman from California (Mr. Horn) is recognized for 5 minutes.
Mr. HORN. Mr. Speaker, today I introduced H.R. 2953, which is
legislation to extend and make social health maintenance organizations
a permanent part of Medicare+Choice. It is an important benefit option
helping seniors maintain a healthy lifestyle longer in their own homes.
As such, it represents a fiscally sound approach to managing our long-
term health care needs in this country, and I urge all of my colleagues
to support this important legislation.
I am fortunate to represent one of the four social HMOs that were
approved as part of the initial Medicare demonstration project in 1985.
This effort, called the Seniors Care Action Network, or SCAN, provides
coordinated personal and health care to more
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than 50,000 Medicare beneficiaries in Los Angeles, Orange, Riverside,
and San Bernardino Counties in southern California.
The concept actually originated more than 20 years ago when a group
of seniors in my district became frustrated with how difficult it was
to get both personal care and health care services. The principle
underlying SCAN is that some individuals, although relatively happy and
healthy, may need some outside assistance to remain in their homes.
These extra services, in the case of SCAN, includes, among other
things, transportation assistance, light housekeeping, prescription
drug services, home health care, adult day care, and caregiver relief
programs. By providing these services, SCAN expects to keep its seniors
healthier longer, relieving the need for them to enter into more costly
long-term care facilities.
Participants are not charged an extra fee for the coordinated care
approach by SCAN. Instead, SCAN is reimbursed by the centers for
Medicaid and Medicare services based on a formula that provides
additional reimbursement for more seriously ill seniors, but a slightly
smaller fee for healthier participants.
The demonstration project, first approved by Congress as part of the
1994 Deficit Reduction Act, has been revalidated by five subsequent
acts of Congress. Unfortunately, only four demonstration sites exist
now, which means that huge groups of seniors are denied coordinated
care as a meaningful alternative to nursing home facilities.
It is time to expand the number of individuals who can benefit from
this option by including the social HMOs as a permanent part of
Medicare+Choice program. My legislation takes the necessary steps to
realize this objective, and I urge all of my colleagues to join with me
to pass this important bill.
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