New Senate Leader Could Bring Changes, AAHomecare Says

Washington

Unable to atone for comments many perceived as racist, Sen. Trent Lott, R-Miss., stepped down from his position as Senate Majority Leader last month, making room for his replacement, Sen. Bill Frist, R-Tenn. Frist’s commitment to restructuring Medicare is well-documented, according to the Alexandria, Va.-based American Association for Homecare.

“If [Frist] becomes Senate Majority Leader … look for a disciplined effort to grapple with the structural problems of Medicare, control expenditures and enact prescription drug coverage,” the association said.

One of Frist’s attempts to streamline the Medicare system was a 2001 bill, S.357, which proposed introducing market forces into the Medicare program. Under the bill’s provisions, Medicare beneficiaries would choose from competing health plans. “This is also the approach President Bush and Rep. Bill Thomas, R-Calif., chairman of the U.S. House of Representatives’ Ways and Means Committee, prefer,” AAHomecare explained.

The association described a few additional Medicare-reform scenarios:

One scenario is based on the provisions of S.358, another Frist-sponsored bill that would allow beneficiaries to obtain prescriptions using a Medicare Prescription Plus plan, offered by a private entity.

Another scenario is based on the provisions of the so-called “tripartisan” prescription drug bill, which would create a voluntary Part D drug program offered by private plans; establish a new Part E program with enhanced benefits and cost-sharing, for patients who opt out of Medicare Parts A and B; and implement a competitive bidding system within the Medicare+Choice program.

In light of all these possibilities, and some lawmakers’ adamant support for HME competitive bidding, “we will have to continue to work hard in 2003,” Tom Connaughton, AAHomecare’s president, told association members. “It is only natural that our members and coalition partners will tire of calling and writing to their elected representatives repeatedly … yet, if the ‘noise’ level significantly drops, the chances for inappropriate congressional action increase dramatically.”

6% of all Medicare fee-for-service claims are fall-related.
— November/December issue of Health Affairs.

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