Providers Praise Congress for Givebacks Bill, But Say They Need More
While they are "grateful" to Congress for passing a $35 billion Medicare relief package before adjourning last week, health care payers and providers will "likely be back for more next year," CongressDaily reports. Reactions to the package, which restored funding cut by the 1997 Balanced Budget Act, include the following:
- Managed care organizations: MCOs "fought off" penalties for exiting the Medicare+Choice market in under two years and received about $11 billion in funding under the "giveback" package. Karen Ignagni, president of the American Association of Health Plans, said, "We are really applauding Congress for taking a step toward a full-scale rescue mission." But, while noting that the law aids HMOs in rural areas, Ignagni added that "more needs to be done for urban areas" and Medicare+Choice plans.
- Hospitals: The package directed about $12 billion toward hospitals, mostly for rural hospitals, teaching hospitals and rehabilitation facilities. Hospitals also received a one-year inflation adjustment instead of the two years they lobbied for. American Hospital Association President Richard Davidson said, "(W)e would have preferred extending that adjustment for two years -- with no further cuts.
- Drug and device makers: The pharmaceutical and medical technology industry "achieved success in key areas." The package contains "Medicare payment and coding mechanisms" to improve access to new technology, requires HCFA to base technology coverage decisions on category rather than brand name, and includes an industry-sought appeals process for coverage denials. Also included is a provision barring Medicare from lowering reimbursement rates for prescription drugs. Ignagni added that the bill provides the "'building blocks' for prescription drug coverage and Medicare reform bound to dominate health care activity" in the 107th Congress (Fulton, CongressDaily, 12/19).