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Budget Cuts Hit Medicare Beneficiaries Some of the nation's most ill and most frail seniors are finding themselves shut out of nursing homes or experiencing difficulty getting the care they need from home health care agencies. A new restrictive Medicare payment system required by 1997 Balanced Budget Act is prompting some health care providers to avoid patients with costly medical needs. Patients who require treatments such as intravenous antibiotics, tube feeding, dialysis, and ventilator support are avoided. Many home care agencies and nursing homes have adopted stricter admission criteria stipulating, for example, that a patient must have a close relative who can provide some of the care. The new payment system has caused federal payments to nursing homes and home health care agencies to plummet over the past two years. New government data, compiled by the Congressional Budget Office (CBO), show that Medicare spending on home health care dropped 45% in the last two fiscal years. More than 1,600 of the nation's 17,000 nursing homes have filed for bankruptcy since the fall of 1998. Indeed Medicare cuts went deeper than Congress anticipated from the 1997 legislation. The CBO estimated that the 1997 measure would reduce projected Medicare spending by $112 billion. Now it appears that the savings will exceed twice that amount. Congress restored about $16 billion in 1998, but an additional round of cuts became effective in 2000. The one acceptable factor causing the lower spending is the effect of a federal crackdown on waste, fraud and abuse that has made doctors, hospitals, home health agencies and other providers more cautious in the claims they submit to Medicare. Federal audits show that Medicare was able to cut the rate of waste, fraud and abuse from $20.3 billion in 1997 to $13.5 billion in 1999. There is support in Congress to restore some funding to Medicare to combat the problem and there may be some action this session. You can help. If you or a family member have experienced problems getting the home health care you need or gaining admission to a nursing home TSCL would like to hear from you. Please write to: TREA Senior Citizens League, 909 N. Washington St. Suite 300, Alexandria, VA 22314. Source: "With Budget Cutting, Medicare Spending Fell Unexpectedly," Robert Pear, The New York Times, May 4, 1999. "Head of Medicare Panel Says Some Payments Should Be Increased, " Robert Pear, The New York Times, June 3, 1999. This article first appeared in Volume 4, Issue 9 of "The Social Security and Medicare Advisor" newsletter (September/1999). To receive future editions of "The Advisor" in its special, free e-mail version, please click here. | ||||||||
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