Washington In what proponents called a "comprehensive" Balanced Budget Act of 1997 reform package, the House of Representatives approved a bipartisan plan that, among other things, would bolster home health care services.

H.R. 3075, the Medicare Balanced Budget Refinement Act of 1999, was passed on a vote of 388-25 in November. At press time, the Senate was working on its own version of such a bill; the two legislative bodies also announced they and the White House had reached a tentative agreement to pass reform legislation before recessing for the year. "We are partners in refining the law to offer more and better care to our nation's seniors and disabled," said Rep. Bill Thomas, R-Calif., Ways and Means Health Subcommittee chairman.

Under the House bill, the annual Consumer Price Index adjustment, which home medical equipment providers lost two years ago when it was frozen under the BBA, would be restored. While the freeze would continue through 2000, providers would receive adjustments of CPI minus two in 2001 and 2002. Congressional budget estimates for the CPI for those years are 2.5 percent, and fee schedules, according to the bill, could be raised 0.5 percent. Full CPI reinstatement would come after 2003.

The bill would also delay the 15 percent scheduled reduction in payments to home health agencies until one year after implementation of the prospective payment system. And it would reinstate $15 billion over five years to nursing homes, HHAs, managed care plans, hospitals and doctors. In addition, it would stop the Department of Health and Human Services from implementing its inherent reasonableness authority until final rules outlining the process have been published.

"Under our proposal, families won't have to drive to the next county to get emergency care, seniors will have the flexibility to enroll in new plans to get the benefits they need, and doctors will make more house calls," said Thomas.

The proposed Senate bill would include a provision to exclude HME providers from the consolidated billing equation. Under the current plan, providers would have to bill HHAs for HME. The HHAs would then bill Medicare. Also, a provision in the Senate bill would delay the 15 percent reduction in payments to HHAs, phased in over a three-year period, until the PPS is implemented.