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91_SR0070
LRB9106102SMdvA
1 SENATE RESOLUTION
2 WHEREAS, The Balanced Budget Act of 1997 established a
3 new reimbursement system for Medicare home health services
4 effective for cost reporting periods beginning on or after
5 October 1, 1997 which has threatened to ruin the home health
6 benefit; and
7 WHEREAS, The Balanced Budget Act of 1997 created an
8 interim payment system which is cost-based with reduced
9 limits and is in effect until a prospective payment system is
10 initiated with cost reporting periods beginning on or after
11 October 1, 2000; and
12 WHEREAS, While the 105th Congress made strides to rectify
13 the interim payment system, the real effect of the Omnibus
14 Reconciliation Act of 1998 was to raise the per-visit
15 reimbursement for home health between only $0.50 and $1.00
16 and the per-beneficiary limits by less than 5% for the
17 majority of home health agencies; and
18 WHEREAS, If the home health program, which is only 9% of
19 the overall Medicare budget, is slashed, other programs will
20 bear the burden, and in many cases Medicare patients will be
21 transferred to the Medicaid program; and
22 WHEREAS, If these patients are not served by home health,
23 they will drive up health care costs in other arenas,
24 including nursing homes, hospitals, and emergency care; and
25 WHEREAS, One out of every 10 Medicare beneficiaries
26 received some form of home health care in 1996; and
27 WHEREAS, On average, a home care visit in 1996 cost
28 between $40 and $140, while the cost of staying in a hospital
29 per day is $2,071, and a skilled nursing facility, $443; and
30 WHEREAS, The average home health agency has seen a 39%
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1 reduction in Medicare revenue since the implementation of the
2 interim payment system; and
3 WHEREAS, Fifty-eight, or 15%, of Illinois home health
4 agencies have closed in the past year; and
5 WHEREAS, Rural home health agencies report revenues at
6 least one-third lower than this same period last year; and
7 WHEREAS, Three-fourths of Illinois Home Care Council
8 freestanding agency members (those not affiliated with a
9 hospital or network) estimate that, unless something changes
10 with the interim payment system, they will be closed within 6
11 months to a year; and
12 WHEREAS, The interim payment system is based on average
13 costs, which creates strong incentives to avoid caring for
14 patients with complex or long-term medical problems, forcing
15 many Illinois home health agencies to choose between staying
16 in business and serving highly complex, high visit volume
17 patients; and
18 WHEREAS, Three prominent public policy research
19 organizations, George Washington University, the Commonwealth
20 Fund, and the Lewin Group, independently concluded that the
21 home health provisions of the Balanced Budget Act of 1997 are
22 causing a crisis in the Medicare home health benefit by: (i)
23 eliminating access to medically necessary home health
24 services for the sickest, most frail Medicare beneficiaries;
25 (ii) rewarding higher cost and penalizing lower cost home
26 health agencies by establishing radically different payment
27 limits that do not reflect current patient mix or efficiency;
28 and (iii) eliminating access to Medicare home health in rural
29 areas; and
30 WHEREAS, The prospective payment system is a system by
31 which home health agencies are paid according to types and
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1 numbers of patients actually served which assures a
2 predictable reimbursement rate and schedule, beneficial to
3 both the federal government and home health agencies;
4 therefore, be it
5 RESOLVED, BY THE SENATE OF THE NINETY-FIRST GENERAL
6 ASSEMBLY OF THE STATE OF ILLINOIS, that we urge Congress to
7 hold the Health Care Financing Authority accountable for the
8 timely implementation of a fair prospective payment system;
9 and be it further
10 RESOLVED, That we urge the federal government to rectify
11 some of the damage wrought by the interim payment system by
12 raising the per-beneficiary and per-visit limits, so that
13 agencies can keep serving patients until the prospective
14 payment system is implemented; and be it further
15 RESOLVED, That we urge the federal government to
16 eliminate the additional 15% cut in reimbursements scheduled
17 for October 2000; and be it further
18 RESOLVED, That we urge Congress to require a
19 representative of the federal government to meet with an
20 Illinois Home Care Council member to discuss the questions
21 and concerns raised by this Resolution; and be it further
22 RESOLVED, That suitable copies of this resolution be
23 delivered to the President pro tempore of the U.S. Senate,
24 the Speaker of the U.S. House of Representatives, and of the
25 other members of the Illinois congressional delegation.