[Congressional Record (Bound Edition), Volume 147 (2001), Part 2]
[Senate]
[Pages 2243-2244]
[From the U.S. Government Publishing Office, www.gpo.gov]



                     HOME HEALTH CARE STABILITY ACT

  Mr. BURNS. Mr. President, I rise today to add my name as a cosponsor 
to the Home Health Care Stability Act of 2001. I commend the leadership 
of my friends Senator Collins and Senator Bond and I am pleased to join 
my many other colleagues in support of this very important piece of 
legislation.
  This bill is two-fold, it will permanently eliminate the automatic 15 
percent reduction in Medicare payments to home health agencies that is 
currently scheduled to go into effect on October 1, 2002 and will also 
extend the temporary 10 percent add-on payment for home health patients 
in rural areas to ensure that these patients continue to have access to 
much-needed care.
  Times are rapidly changing. Today more than ever, patients are 
spending less time in the hospital. More and more, we are seeing 
procedures done on an outpatient basis, with recovery and care for 
patients with chronic conditions taking place in the home. In addition, 
in my State of Montana, for example, the number of elderly who are 
chronically ill or disabled continues to grow. How do we care properly 
and compassionately for these individuals? As our population ages, the 
answer to this question becomes more and more important.
  Increasingly, the answer for many is home health care. Home health 
care is an important part of Medicare in which seniors and the disabled 
can get the care they need, where they want it: in the comfort and 
security of their own homes. Additionally, home health care is a 
necessity because, for many, their health or physical condition makes 
it almost impossible to leave home. Not only is it convenient, but much 
more importantly, patients love it. They

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love it because home health care allows seniors and others with 
disabilities a feeling of independence and dignity, despite their 
illnesses. Often home health is an alternative to more expensive 
services in hospitals, and, thus, is a cost-effective alternative to 
providing care.
  However, folks, there is a home health care crisis--too many seniors 
and disabled who should be receiving health care services at home are 
not getting it. This is wrong. Many of our most frail and vulnerable 
have had to be repeatedly hospitalized with problems that could have 
been avoided had they been continuing to receive their home health 
benefits. Others are trying to pay for the care themselves, often on 
very limited means. Some are going without care altogether.
  By the late 1990s, home health care was the fastest growing component 
of Medicare spending, growing at an average of 26 percent annually. We 
all know what happened next--in an effort to balance the budget and 
make the home health program more cost-effective and efficient, 
Congress in the Balanced Budget Act of 1997, BBA, tried to cut the 
growth in Medicare spending. Unfortunately, the real results of this 
action went much farther than we intended, in large part because of 
faulty implementation and excessive regulatory requirements of the 
Health Care Financing Administration, HCFA. As the cuts and regulations 
spun out-of-control, health care providers struggled to survive, while 
many were forced to close their doors entirely. Ultimately, patients 
suffered the most. This story applies to patients and providers in all 
parts of Medicare, hospitals, nursing homes, home health care 
providers, everyone.
  Now, on the horizon, is yet another 15-percent cut that would put 
many of our already struggling home health agencies at risk and would 
seriously jeopardize access to critical home health services for 
millions of our Nation's seniors. In my State of Montana, access to 
home health care is already a problem for many, we cannot make this 
problem worse. Home health and, most importantly, the patients who 
depend on its services cannot afford this. We must act now.
  I am indeed proud that last year we passed legislation, the Medicare, 
Medicaid, and S-CHIP Benefits Improvement and Protection Act, which 
provided some relief to struggling home health agencies. However, I do 
not think that it went far enough. First, we must eliminate the 15 
percent cut completely. The simple fact is that an additional 15 
percent cut in Medicare home health payments would spell death for 
those low-cost agencies which are currently struggling to hang on, and 
it would further reduce seniors' access to critical home care services. 
We have already delayed this 15 percent cut three times--the time has 
come to do away with it once and for all. Secondly, we must also make 
permanent the temporary 10 percent add-on for home health services 
furnished patients in rural areas. This, too, was included in last 
year's legislation, this bill would make it permanent.
  In Montana, we know too well how very expensive it is for home health 
agencies to deliver services to rural patients. They have to travel 
long distances, and it takes a long time to reach those patients. That 
all adds to the cost.
  The Home Health Care Stability Act will provide essential relief for 
our home health agencies that are struggling to make ends meet. I am 
proud to add my name as a cosponsor of this important piece of 
legislation. I hope we can get quick action on this bill to ensure that 
seniors and the disabled have appropriate access to quality home health 
care.

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