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VGM Update - Jan. 28th, 2005 |
Jan 28 2005 10:20AM |
Nursing Homes Just Want Medicare Funding Left As Is
President Bush will not unveil his budget until next month, but health care providers are already making
their cases to avoid what appears an inevitable round of Medicare payment reductions. Wednesday was the
nursing home industry's turn. "We're not asking for more money. Just please, leave us alone," Stephen
Guillard, CEO of the nursing home company Harborside Healthcare Corp., told a briefing of health
reporters. Nursing homes are worried that Congress will take a recommendation from the Medicare
Payment Advisory Commission (MedPAC) to freeze payments, costing the industry an estimated $500
million next year. Congress might also order the administration to eliminate special temporary payments
that provide another $1 billion annually. While nursing homes' profit margins for Medicare are healthy,
they lose money on Medicaid, Guillard said. And Medicaid patients make up the majority of nursing home
residents. Guillard pulled no punches, predicting dire consequences if funding is cut. "Will we have chaos;
will we have bankruptcies? Absolutely," he said.
The nursing home industry tends to have less clout than groups representing doctors and hospitals, but this
year it has its own not-so-secret weapon -- Tom Scully, the former administrator of the Centers for
Medicare and Medicaid Services. Scully told reporters that reducing payments for nursing homes at this
point "is just flat out stupid," particularly when there is "a tidal wave of baby boomers" nearing the age at
which nursing home care will become necessary. Scully and Guillard also pointed out the nursing home
industry has done more than most other healthcare sectors to improve its quality industry-wide, and cutting
payments would jeopardize that progress. "We're so far ahead of the curve" on quality, said Guillard. "We
just want to stay there." Other industry groups are expected to mount their own campaigns in the coming
weeks for what has come to be known as "reverse pork," in which providers compete not to get cut.
(CongressDaily, 1/27) DOES THIS LOOK STRANGE (Scully’s action) TO ANYONE? Where was Mr.
Scully’s concern for the beneficiary when he supported NCB? Wouldn’t it be cheaper Tommy, if Medicare
provided a means for beneficiaries to be able to stay at home rather than have them institutionalized?
Clinton Cautions Administration About Cutting Medicaid
Democrats are planning to oppose any GOP efforts to trim Medicaid spending, Sen. Hillary Rodham
Clinton (D-NY), said today, adding that changes to the program are possible. "I am open to Medicaid
reform, any program can get creaky," she said at a conference sponsored by the seniors' group Families
USA. "But establishing block grants would gut the program, and that is not an option." The president's
budget is expected to include Medicaid cuts, possibly including proposals to replace the state-federal
matching funds with capped federal funding. Clinton said Democrats also will oversee the implementation
of the prescription drug law, especially the transition period for so-called dual-eligibles who will be moved
from Medicaid to Medicare. But Clinton said automatic enrollment in a randomly chosen plan could leave
some seniors in the wrong plan -- one that might not cover the drugs they take. And since companies can
change the lists of drugs they cover, known as formularies, or drop out of the Medicare plan altogether,
seniors might have difficulty navigating the program. "Can we put that responsibility on our already
overworked caregivers?" she asked. HHS officials said last week the automatic enrollment was aimed at
preventing dual-eligible seniors -- who are among the sickest and poorest Medicare beneficiaries -- from
experiencing gaps in coverage. Other seniors will have about six months to enroll in a plan. Also today at
the annual meeting of the National Academy of Social Insurance, a panel of analysts argued that easing
restrictions on drug imports would be unlikely to save consumers are much as they think. "The bottom line
is there will not be significant savings," said Wharton School professor Patricia Danzon. One major reason
27 January 2005
is that the entire European Union accounts for only 25 percent of the world's drug market, and Canada only
2 percent, while the United States consumes nearly half the world's prescription drugs. "So the percentage of
the U.S. market that could be sourced from abroad is quite small," she said. At the same time, she said,
"countries with lower prices are not getting access to the newest drugs." Acting FDA Commissioner Lester
Crawford agreed, pointing to a Bush administration report issued last month that concluded that opening
U.S. borders could reduce drug research and development spending by $189 billion a year and result in the
loss of four to 18 new drugs annually. But Kirsten Sloan of the seniors' group AARP said re-importation
remains a potent political issue, particularly because "the Internet and bus trips to Canada are making
consumers aware that there are lower-cost drugs out there." And while even AARP believes that drug
imports are not the answer to drug price problems, she said, "It keeps the spotlight and keeps the pressure on
the drug industry." (CongressDaily, 1/27)
House GOP Releases New Assignments
House Speaker Hastert (R-IL) Wednesday released a nearly complete list of Republican committee
assignments for the 109th Congress, after approval by the House Republican Conference. The largest
number of remaining vacancies are on the House Homeland Security Committee, which is being converted
to a permanent standing committee from temporary select status, and on the House Budget Committee,
where three slots have yet to be filled by the House Appropriations Committee. Here are the new GOP
members, who will be on committees that have jurisdiction over Medicare / Medicaid.
BUDGET: Reps. Dan Lungren, Calif.; Pete Sessions, Texas; Paul Ryan, Wis.; Jeb Bradley, N.H.;
Patrick McHenry, N.C.; Connie Mack IV, Fla., and Mike Conaway, Texas. Besides the three vacant
seats reserved for members of the House Appropriations Committee, there is one more vacancy to be filled.
ENERGY AND COMMERCE: Reps. Sue Myrick, N.C.; John Sullivan, Okla.; Tim Murphy, Pa.;
Michael Burgess, Texas, and Marsha Blackburn, Tenn.
WAYS AND MEANS: Reps. Thomas Reynolds, N.Y.; John Linder, Ga.; Melissa Hart, Pa.; Bob
Beauprez, Colo., and Chris Chocola, Ind.
HOUSE DEMOCRATIC COMMITTEE ASSIGNMENTS
The House Wednesday approved a list of new Democratic appointments to House committees.
Appointments must still be made to the Homeland Security Committee, and there are vacancies on several
other panels. Here is a list of new Democratic members of committees that have jurisdiction over Medicare /
Medicaid. Most are freshmen but some are veterans taking on new assignments.
BUDGET: Reps. William Jefferson, La.; Tom Allen, Maine.; Ed Case, Hawaii; Cynthia McKinney, Ga.,
and Henry Cuellar, Texas.
ENERGY AND COMMERCE; Reps. Jay Inslee, Wash.; Tammy Baldwin, Wis., and Mike Ross, Ark.
(Note; Rep. Ross and his wife own and operate an independent DME / Pharmacy.)
WAYS AND MEANS: Reps. Mike Thompson, Calif.; John Larson, Conn., and Rahm Emanuel, Ill.
NOTE: If your member of congress has been recently appointed to one these important committees listed
above. Ensure you contact their local office (if you need assistance go to http://dclink.vgm.com) and
congratulate them on the matter of the appointment. Let the staff member understand your concern for
National Competitive Bidding (NCB) and its potential impact on the beneficiary, and that you look forward
to working with your member of congress on important Medicare/Medicaid issues in the upcoming 109th
Congress.
John E. Gallagher, Vice President of Government Relations 800.642.6065 ext. 6503
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