[Congressional Record Volume 149, Number 35 (Wednesday, March 5, 2003)]
[Senate]
[Page S3181]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. HATCH (for himself, Mr. Graham of Florida, Mr. Kennedy, 
        Mr. Coleman, Ms. Mikulski, Mr. Allard, and Mr. Dayton):
  S. 526. A bill to amend title XVIII of the Social Security Act to 
improve access to Medicare+Choice plans for special needs medicare 
beneficiaries by allowing plans to target enrollment to special needs 
beneficiaries; to the Committee on Finance.
  Mr. HATCH. Mr. President, I rise today to introduce a bill designed 
to provide assistance to vulnerable Medicare beneficiaries: the 
Medicare Improvements for Special Needs Beneficiaries Act of 2003. This 
legislation will improve access to health care for frail and elderly 
Medicare beneficiaries who reside in nursing homes or their local 
communities.
  Approximately 6 million Medicare beneficiaries are eligible for both 
Medicare and Medicaid coverage. Known as ``dual eligibles,'' these 
beneficiaries are the most vulnerable group of Medicare recipients. 
They are elderly or disabled and poor. Many have serious health 
concerns and complex medical, social, and long-term care needs. As a 
result, dual eligibles represent a disproportionate share of Medicare 
spending.
  To address the concerns of dual eligibles, a small number of health 
plans specialize in providing quality coordinated care to frail, 
elderly Medicare beneficiaries through demonstrations and the 
Medicare+Choice Program. These specialized plans include innovative 
clinical models of care that improve care and health outcomes while 
reducing medical costs. Today, approximately 25,000 Medicare 
beneficiaries, most of whom reside in nursing homes, receive their 
health care through these specialized plans.
  Through these plans, physicians and nurse practitioners work together 
to provide as much primary, preventive, and acute care as possible on 
site--in a nursing home facility or in the patient's home. For those 
beneficiaries residing in nursing homes, this means fewer trips to the 
emergency room; for those still living at home, it delays nursing home 
placement. If enrollees can be treated successfully without a trip to 
the hospital or placement in a nursing home, they remain healthier and 
costs to the Medicare Program are reduced.
  Currently, these specialized plans are facing regulatory barriers 
that prevent them from becoming permanent Medicare+Choice Program 
options. The Medicare Improvements for Special Needs Beneficiaries Act 
provides improved beneficiary access to Medicare+Choice plans by 
removing these barriers and allowing plans to specialize in serving 
dual eligible, institutionalized, and other frail beneficiaries. 
Specifically, the bill would allow a special Medicare+Choice program 
designation so these plans may continue to target enrollment to the 
frail elderly and provide appropriate health care to this vulnerable 
population.
  Both the President and Members of Congress have stated their 
commitments to improving services provided to Medicare beneficiaries. 
In fact, when President Bush visited Minneapolis last July, he 
expressed his strong support for the Evercare program by saying that 
``government should act to strengthen these private health insurance 
options, not replace them. By relying on competition and patient's 
choice and innovative programs like Evercare, we will protect our 
seniors now, and offer many new lifesaving services to seniors in the 
future and preserve our private health care system.''
  These specialized programs are fulfilling the original promise of the 
Medicare+Choice Program to not only protect our Medicare beneficiaries 
but, in addition, these program improve health care quality and lower 
health care costs. This legislation is a no-cost way to continue this 
effort. Evercare plans serve a unique and valuable purpose for a 
vulnerable segment of our society. I hope my colleagues will join me in 
supporting this important bill.
                                 ______