FOR IMMEDIATE RELEASE, Contact: (202) 225-3625
September 21, 1998
No. FC-34A
Chairman Bill Archer (R-TX), Chairman of the Committee on Ways and Means, today announced that on Friday, September 18, 1998, the Committee ordered favorably reported, by voice vote, the following measures: H.R. 3511, a bill to provide exceptions to the imposition of civil money penalties in cases of payments to beneficiaries, as amended; H.R. 4377, a bill to expand the Medicare Payment Advisory Commission, without amendment; and H.R. 4567, the "Medicare Home Health Care Interim Payment System Refinement Act of 1998," as amended.
DESCRIPTION OF H.R. 3511 AS APPROVED:
H.R. 3511 would modify a provision in the Health Insurance Portability and Accountability Act (HIPAA) (P.L. 104-191) in two ways: (1) the Inspector General of the U.S. Department of Health and Human Services (HHS) would be able to create exceptions -- known as "safe harbors" -- to the fraud and abuse rules so as to exclude specific practices from the HIPAA provisions, and (2) medical facilities would be allowed to obtain advisory opinions from the Inspector General. These opinions would provide legal and regulatory guidance to medical facilities as to whether payment of coinsurance or other premiums violates HIPAA's fraud and abuse provisions. Finally, H.R. 3511 would also give the Secretary of HHS interim final rule-making authority which would speed up the process whereby these "safe harbors" and advisory opinions become effective.
DESCRIPTION OF H.R. 4377 AS APPROVED:
H.R. 4377 would increase the number of commissioners appointed to the Medicare Payment Advisory Commission (MedPAC) to 17 from the current 15.
DESCRIPTION OF H.R. 4567 AS APPROVED:
H.R. 4567 would increase the per beneficiary limit for those home health care agencies whose per beneficiary limit is below the input price adjusted national median limit. The adjustment would be equal to one half of the difference between the agency's per beneficiary limit and the input price adjusted national median limit. Home health agencies who begin treating Medicare patients on or after October 1, 1998, would have per beneficiary limits equaling 75 percent of the input price adjusted national median limit. In addition, the bill would increase the Medicare home health care per visit limit to 108 percent of the national median cost.
The bill would also require the Secretary of HHS to submit to Congress a report describing: (1) all of the research to date on the development of a prospective payment system for Medicare home health services, (2) a schedule for implementation of the Balanced Budget Act of 1997 (BBA) (P.L. 105-33) mandated prospective payment system, and (3) the Secretary's recommendations for one or more alternatives to provide savings equal to the estimated savings from the 15 percent reduction in payment limits scheduled for fiscal
year 2000. MedPAC would be required to submit a report to Congress no later than 60 days after the date that the Secretary submits her report. In addition, MedPAC would have to include in its June 1999 report an analysis of whether changes in law made by the BBA, and amended by this bill, would impede access to home health services. The General Accounting Office would be required to conduct an audit of the Health Care Financing Administration's expenditures for research related to the development of a prospective payment system for Medicare home health services.