BBA Relief Progress
Both the House Ways and Means Health Subcommittee and the Senate Finance Committee presented BBA relief proposals that total between $25 and $30 billion over five years. The Ways and Means plan includes a full market basket update to Medicare inpatient and outpatient services for next year, a two-year Indirect Medical Expense (IME) freeze, small increases in reimbursements for bad debt and specialty hospitals and an expansion of Medicare reimbursement for telemedicine services. The Senate Finance package includes two years of a full market basket update, but only for inpatient services and with a drop to market basket minus 1 in 2003, a two-year IME freeze, and an expansion of telemedicine services.
Partners’ advocacy efforts are focused on securing more years on the IME adjustment and making certain that the final deal contains at least two years of full inflation updates for all services.
Medicare Coverage News
The House and Senate BBA relief plans propose to cover
a variety of new services for Medicare beneficiaries—periodic colonoscopies; nutritional therapy for beneficiaries with diabetes, cardiovascular disease, or kidney disease; unlimited coverage of immunosuppressive drugs for transplant patients; a waiver of the waiting period for those suffering from Lou Gehrig’s disease; expanded screening for glaucoma; and more frequent pap smears and pelvic exams for women. Most are likely to become law.
States Ranked on Medicare Quality
Massachusetts ranks fifth in the nation in a new evaluation of the quality of health care provided to Medicare recipients in fee-for-service health plans. The rankings, based on a review of 24 clinical areas most commonly associated with elder care, were published in a recent issue of the Journal of the American Medical Association (JAMA).
In Massachusetts:
• Supplemental state budget House Ways and Means Chairman Paul Haley released his supplemental FY01 budget, which does not include Governor Cellucci's proposed $400,000 reserve fund for state costs associated with the new managed care reform law.
• DPH Proposes New MRI Rules In August, the Department of Public Health (DPH) proposed to revise its determination of need guidelines on magnetic resonance imaging. The new rules would expand the availability of MRI services statewide. A copy of the proposal is available from Partners Government Relations at 617-278-1041.
• Worth Noting DPH has issued “best practice” guidelines for hospitals regarding ambulance diversions. Copies are available through Partners Government Relations at 617-278-1041. Also available are a summary and the text of the new emergency medical services system law which took effect in September. There is still no word from DPH on the guidelines for applying to perform cardiac surgery at the community level. The Massachusetts Medical Society committee on legislation voted September 26 not to support state ballot initiative number 5, which includes sections on universal health care and other managed care reforms.