ACTION

FROM THE COMMITTEE ON WAYS AND MEANS

FOR IMMEDIATE RELEASE, Contact: (202) 225-3625
October 21, 1998
No. FC-36A


Archer Announces Ways and Means Provisions
Included in the Conference Agreement for H.R. 4328,
the "Omnibus Consolidated and Emergency Supplemental
Appropriations Act, 1999"

Congressman Bill Archer (R-TX), Chairman of the Committee on Ways and Means, today announced the details of major provisions within the jurisdiction of the Committee on Ways and Means that have been included in the revenue and Medicare part of the conference agreement for H.R. 4328, the "Omnibus Consolidated and Emergency Supplemental Appropriations Act, 1999."   Specifically, the bill's revenue and Medicare provisions contained in other legislation considered by the Committee on Ways and Means, and recently passed by the House, including H.R. 4738, a bill to extend certain expiring provisions and provide tax relief for farmers and small businesses, as well as H.R. 4567, the "Medicare Home Health Care Interim Payment Refinement Act."

DESCRIPTION OF REVENUE PROVISIONS:

Extension of Expiring Tax Provisions

Extension of Expiring Trade Provisions

Other Tax Provisions

Revenue Offset Provisions

Tax Technical Corrections Provisions--Various technical corrections to previously enacted tax legislation are included.

Emergency Tax Relief for Farmers

DESCRIPTION OF MEDICARE PROVISIONS:

Medicare Home Health Provisions

The Medicare home health provisions 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 third 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 Medicare home health care per visit limit would increase to 106 percent of the national median cost. The 15 percent reduction applied to home health care agencies beginning October 1, 1999, would be delayed one year to coincide with the implementation of the Propsective Payment System.

These provisions would also require the Secretary of Health and Human Services (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, and (2) a schedule for implementation of the Balanced Budget Act of 1997 (BBA) (P.L. 105-33) mandated prospective payment system. The Medicare Payment Advisory Commission (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 provision, would impede access to home health services. The U.S. 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.

Revenue Offset

The Medicare home health provisions would be offset by a change in the tax rules for gambling winnings. The existence of a "qualified prize option" would be disregarded in determining the taxable year in which any portion of a qualified prize is to be included in income. The proposal would apply with respect to any qualified prize to which a person first becomes entitled after the date of enactment, or on or before the date of enactment if the person has an option to receive a lump-sum payment only during some portion of the 18-month period beginning on July 1, 1999.

Exceptions to the Imposition of Civil Money Penalties

These provisions 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 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. The Secretary of HHS would be given interim final rule-making authority which would speed up the process whereby these "safe harbors" and advisory opinions become effective. These provisions would place limits on the Inspector General's safe harbor authority relating to providers or health care facilities providing Medicare supplemental coverage to end-stage renal disease beneficiaries. The duration of the safe harbor authority for this particular issue would be limited to a two-year period which commences on the date that the rule is promulgated. These provisions also would stipulate that the Comptroller General shall conduct a study that compares any disproportionate impact on specific issuers of the purchase of Medicare supplemental policies for end-stage renal disease patients.

Expansion of the Medicare Payment Advisory Commission

The number of commissioners appointed to the MedPAC would be increased to 17 from the current 15.