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LEGISLATION & Regulations

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LEGISLATION & Regulations

APTA Opposes Medicare Limits

The Medicare reform proposal passed in late June by the House of Representatives is vehemently opposed by the American Physical Therapy Association. The proposal, which includes a provision establishing an arbitrary annual limit of $900 for outpatient rehabilitation services is viewed by the association as a cut in Medicare benefits, according to a recent APTA news release.

This limit will be imposed on rehabilitation agencies, comprehensive outpatient rehabilitation facilities, physical therapists in private practice, physician practices and public health clinics. However, the one setting that will be exempt from the proposal is outpatient hospital departments.

In the news release, APTA President Jan K. Richardson, PhD, PT, OCS, said, "The House bill is simply not prudent policy. Arbitrary limits or caps on services are merely cuts in Medicare benefits. Medicare patients require considerably more care, and even one diagnostic condition could easily exceed this limit."

She added, "If a Medicare beneficiary sustained a knee injury similar to that of President Clinton, the limit would be exceeded after only one week of physical therapy treatment."

The arbitrary limit on outpatient rehabilitation services would decrease patient access to needed care, especially in rural areas where hospitals are scarce, noted the news release. Such restrictions further minimize the availability of physical therapy services based upon the utilization of hospital-based physical therapists.

U.S. Court Affirms Ruling

On July 1, 1997, the United States Court of Appeals affirmed the Dec. 20, 1996, judgment of the U.S. District Court for the District of Columbia in the Paralyzed Veterans of America's case against the owners and operators of the MCI Center, the new Washington, DC, sports arena now under construction. In that case, Judge Thomas F. Hogan ruled that wheelchair seating location in the arena must provide wheelchair users with seating that enables them to see as much of the action as the rest of the spectators.

"We are thrilled that a panel of the U.S. Court of Appeals has ruled unanimously in favor of the Paralyzed Veterans of America," said Kenneth C. Huber, Paralyzed Veterans of America president, in a recent PVA news release. "We are eager, as we have always been, to work closely with the owners and operators of the MCI Center to ensure that the needs of people with disabilities are addressed."

Lawrence Hagel, deputy general counsel of the PVA, explained that this is the first Appellate Court decision of its kind and, therefore, it will have a direct impact on similar pending lawsuits across the country. "The real winners are current and future generations of people with disabilities who will be able to equally enjoy all that the MCI Center has to offer," he said.

HHS Program Gives Elderly Computers

In an effort to give older Americans access to the Internet and make them better informed users of Medicare, Medicaid and other related programs, the Department of Health and Human Services announced a new "Computers for Seniors" program.

More than 500 surplus computers will be donated by HHS' Health Care Financing Administration to the Computers for Seniors project. The computers will be given
to senior centers located throughout the country that are supported through the HHS' Administration on Aging.

"HHS is committed to using Internet technology to serve all Americans better," said Secretary Donna E. Shalala in a recent news release. "Our department-wide web presence now includes some 62 sites, covering the full range of HHS activities and responsibilities. Many of these HHS sites, as well as many Web sites outside of HHS, will be of special value to older Americans, and we want to help them use this resource to the fullest."

The program will provide personal computers and basic Windows and DOS operating software to senior centers nationwide. Senior centers will be responsible for installing and maintaining the equipment, as well as providing a modem and additional phone lines as needed.

HCFA is expected to soon announce which senior centers will receive the computers, which are slated to be installed by the end of August 1997.

Retirees Help Fight Fraud

The Department of Health and Human Services recently announced a $2 million grant program to recruit and train retired doctors, nurses, accountants, investigators, attorneys, teachers and other professionals to detect fraudulent activities in Medicare and Medicaid, according to a report in a recent issue of the American Hospital Association's newsletter.

Volunteers will work in their own communities in 12 states under the two-year demonstration project to help identify deceptive health care practices like overbilling, overcharging or providing inappropriate or unnecessary services.

"We know that in order for our antifraud efforts to really pay off, we need to look beyond Washington, and there is no better way to do this than to help older volunteers across the country to become the eyes and ears of their communities," said HHS Secretary Donna E. Shalala.

Hospital Medicare Payments Stagnant

Hospitals will receive no increase in Medicare payments in fiscal year 1998, recommended HHS Secretary Donna E. Shalala in a move to support the bipartisan agreement to balance the federal budget.

Under current law, Medicare payments to hospitals would be based on a "market basket" index and would increase 2.8 percent in FY 1998. But Shalala recommended not increasing payments to help reduce growth in Medicare spending by a total of $115 billion over the next five years. Medicare savings are one element of the bipartisan plan for a balanced budget by fiscal year 2002.

"Medicare must become an increasingly prudent purchaser of health care services, and those who provide services to Medicare beneficiaries must do their fair share toward a balanced federal budget by increasing their efficiency and effectiveness," said Shalala in a recent HHS news release.




     

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