The Future of Aging Blog

President Obama has not given up on health care reform this year, and neither has Sen. Max Baucus (D-Mont.), chair of the Senate Finance Committee.

However, two other measures will take immediate precedence on Capitol Hill over the next couple of weeks; another jobs bill and budget reconciliation legislation for fiscal 2010.

In the meantime, several health issues that originally were covered in comprehensive health care reform must get done without further delay, and separate legislation is being introduced to move these issues forward. It is as yet unclear whether these measures will move separately or as part of some larger measure yet to be determined.

Medicare physician fee schedule fix: Congress passed temporary relief back in December, but that measure expires at the end of this month. Skilled nursing facilities’ Medicare Part B therapy fees are based on the physician fee schedule, and could fall by 21% if payment relief is not extended. We are urging Congress to take prompt action on this issue. We have heard that provisions for another doc payment fix could be added to the jobs bill that is to be taken up next week.

Medicare therapy caps exceptions process: the process that facilitates beneficiaries’ getting coverage for the full amount of therapy they need expired on December 31. This year’s caps are $1,860 for physical and speech therapy combined and another $1,860 for occupational therapy. If the exceptions process is not renewed soon, many beneficiaries will begin to hit the caps. Sen. John Ensign (R-Nev.) has drafted legislation that should soon be introduced to extend the exceptions process. This is another measure that could be added to the jobs bill. We are strongly supporting the extension and have an alert and letter up on Contact Congress for members to do their own advocacy on it.

Extension of increased federal Medicaid match: the additional Medicaid money that states received under last year’s economic stimulus package is due to expire December 31, 2010. We wouldn’t presume to tell you the pressure that state budgets are under and the cuts that have been made to Medicaid even with the additional federal funding. Senators John Rockefeller (D-W.V.) and Harry Reid (D-Nev.) introduced legislation on Feb. 4 to extend the additional Medicaid funding for another six months. We strongly support the extension and will have an alert and letter up on Contact Congress as soon as possible.

Medicare/Medicaid fraud: Sen. Charles Grassley (R-Iowa) has introduced S. 2964 to prevent waste, fraud and abuse in the Medicare and Medicaid programs. The legislation includes a number of provisions that were in the Senate’s health care reform bill, including a requirement for health care providers to have compliance programs with specific elements; a shorter, one-year time limit for submitting Medicare claims; and requirements for home health care and durable medical equipment to be ordered by a physician or “enrolled Medicare-eligible professional” and to be based on a face-to-face meeting with the Medicare beneficiary. No action has been scheduled on this measure as yet.

Fiscal 2011 budget: House subcommittees are beginning hearings on the President Obama’s budget proposals for next year. Right now the assumption is that Medicare and Medicaid will be dealt with under health care reform legislation. The skilled nursing facility and home health care payment updates for 2011 are preserved under that legislation, but we continue to remind Congress of the need for the updates in case separate Medicare legislation develops.

The administration proposed no increase in funding for the Section 202 senior housing program, although they appear to have heard our recommendation that the program become a platform for supportive services that would enable elders to remain longer in their homes. We are advocating for a significant increase in funding for the program and are pointing out that construction of new affordable housing units for seniors would put thousands of people to work.

We were generally pleased with the funding proposals for Older Americans Act programs that finance home and community-based services, since the Administration on Aging would gain an overall 7% increase in funding. However, congregate and home-delivered meals programs would get increases less than the rate of inflation, so we are working on boosting funding for those programs.

That’s it for now. Please let me know if you have any questions. Washington is bracing for another “snowpocalypse” today – we are hoping the snow gods will get this all out of their system before the Future of Aging Service Conference (FASC).