Tag Archives for Medicare

Bill Seeks to Soften Impact of Medicare Cuts

Published in Pawtucket Times on September 23, 2002

One week to go before the new federal Medicare cuts go into effect – cuts that will slash $1.7 billion in 2003 funding for the developmentally disabled and frail seniors in nursing facilities.

According to the American Health Care Association (AHCA), over the next two year’s cumulative Medicare cuts, called the “Medicare Cliff,” will total a whopping $5.2 billion.

Meanwhile, AHCA, representing 12,000 nonprofit long-term care providers, has been lobbying Congress for federal relief from the draconian reductions.

A new ad appearing in the Capitol Hill newspaper, Roll Call, reminds lawmakers that the upcoming cuts could lead to reduced nurse staffing and puts residents at risk.

In the upcoming November elections, voters might just get riled up too, over Medicare being cut by 10 percent, says AHCA.

The Roll Call ad notes a recent national survey of 800 persons found that 84.6 percent of the respondents opposed cutting Medicare funding for nursing facility care by 10 percent.

Additionally, 64.1 percent were less likely to vote for a candidate running for Congress if they knew that the candidate “voted to cut Medicare funding for nursing facility for nursing facility care by billions.”

Charles H. Roadman, II, M.D., AHCA’s president and CEO noted that a recent study by the University of North Carolina School of Public Health confirms the devastating impact of the impending Medicare cuts.

The study says that cuts could lead to reduced numbers of staff caring for seniors in nursing facilities, thus jeopardizing quality of care.

“At a time when the Centers for Medicaid and Medicare Services (CMS) and nursing care providers are actively pursuing efforts to improve the quality of care in nursing facilities throughout the nation, new federal cuts to Medicare are inconsistent with achieving this important goal,” says Dr. Roadman.

Roberta Hawkins, executive director of the Alliance for Nursing Home Care and state ombudsman agree with Roadman’s assessment.

“Huge Medicare cuts pull the carpet from under the federal quality initiatives that take effect across the country in October,” she tells All About Seniors. “The right hand of the federal government does not seem to know what the left hand is doing.”

According to Hawkins, the staffing shortage in Rhode Island is having a drastic impact on the quality of care delivered to more than 10,000 residentes.

“The upcoming Medicare cuts combined with an outdated Medicaid payment system will only further compromise patient care in the Ocean State,” she says.

U.S. Rep. James Langevin and House colleagues today announced a legislative fix that would delay scheduled cuts for nursing facilities and assisted living facilities in Rhode Island.

Langevin is co-sponsoring the Medicare Skilled Nursing Beneficiary Protection Act, sponsored by Congressman Tom Allen (D-ME), that would extend Medicare reimbursement add-ons for three years, through 2005, to allow the Bush administration more time to implement an adequate reimbursement formula for skill nursing facilities.

Langevin and the other bill sponsors hope this new timetable will obviate the need for further cuts in Medicare reimbursement rates, which would place severe financial burdens on nursing facilities.

Langevin stated that unless Congress acts this year, Medicare funding for skilled nursing care will be cut by 10 percent in 2003 and 19 percent in 2004 – translating to cuts of nearly $ 35 per patient per day in 2003 and $68 in 2004.

The Rhode Island congressman believes that in the Ocean State, the Medicare cuts will be even greater than the national average totaling $ 38.81 in 2003 and $ 76.90 in 2004.

“Difficult decisions were made in 1997 with passage of the Balanced Budget Act, and some of the changes were not implemented as Congress intended,” Langevin said. “The Medicare Skilled Nursing Beneficiary Protection Act will postpone further cuts and ensure that critical funding remains available for thousands of Rhode Islanders who rely on skilled nursing services.”

According to Langevin in mid-1998, the new Medicare prospective payment system (PPS) was implemented for skilled nursing care, as mandated in the 1997 Balanced Budget Act (BBA).

He noted that the new system resulted in cuts far deeper than intended by Congress.

In 1999 and 2000, Congress temporarily restored some of the unintended cuts as part of the Balanced Budget Refinement Act (BBRA) and the Benefits Improvement and Protection Act (BIPA).

These temporary add-ons helped restore beneficiary access to care, but overall Medicare funding levels for skilled nursing facilities continue to be below BBA projections, Langevin said.

“I am wholly committed to making the restorations of 1999 and 2000 permanent,” he said.

“We cannot turn our backs on a generation who built and defended the very foundation of this nation. They answered the call of our nation -now we must answer theirs.”

Seniors Must Educate Themselves to Push for Political Policy Reforms   

Published in the Pawtucket Times on July 22, 2002

Did you go to the Bristol 4th of July parade?

Or perhaps were you one of hundreds of people who gathered at Slater Mill Historic Site to hear U.S. Rep. Patrick Kennedy’s announce his bid for re-election.

If you attended one of these events or one of the hundreds of others scattered throughout the Ocean State, you probably ended up meeting gubernatorial, legislative, statewide or congressional candidates who were seeking high visibility with voters and potential votes from old friends and new acquaintances.

The clock is ticking.

With about seven weeks before the Sept. 10 primary, Rhode Island political candidates are scrambling to fill up their calendars with the dates of hundreds of “must-attend” events.

Political wisdom tells us that these candidates are more responsive to attending coffees, festivals and events that will attract older voters. This is because seniors as a group tend to get to the polls more often than other younger demographic groups. Years of research on voting trends bear this out.

According to the Bureau of the Census, in the 1996 presidential election, voter turnout among Americans 65 and older was 67 percent, only 10 percent lower than their registration rate of 77 percent. In that presidential election cycle, voter registration and turnout for Americans 50 and over was about the same as for Americans over age 65 (64.4 percent). Yet only 31 percent of voters between the ages of 18 and 20 cast a vote in the presidential election of 1996.

Can this trend take hold for the 2002 Rhode Island elections? You bet.

The question is – are federal and state policy makers prepared to confront the changes that will occur with an aging America?

In the next Congress, both Republican and Democratic leadership must work closely together to develop sound aging policy initiatives.

Federal lawmakers must quickly come to grips with how to assist seniors to pay for costly long-term care while ensuring quality services are provided.  They must continue their efforts to hammer out a bipartisan law to make pharmaceutical drugs more affordable and to keep both Medicare and Socially Security financially solvent.

At the state level, the Gray Panthers of Rhode Island working in collaboration with the Rhode Island Forum on Aging and the Rhode Island Minority Elder Task Force, move to educate senior voters about state and federal aging issues. Funded by the Rhode Island Foundation, the Senior Agenda/Election 2002 project will identify priority state and federal aging issues, solicit candidate positions through a questionnaire and hold four regional forums to further discuss positions.

Become an educated voter. Learn more about the aging issues of important to you by carefully reading the political candidate’s positions in the written materials to be made available to you by the Senior Agenda/Election 2002 project.

At coffees, festivals and political events that you attend before the September primary and up to the November election, tell any gubernatorial, statewide or legislative candidates you meet to make further reforms net year to the state’s pharmaceutical program (RIPAE). Tell them about the need for assisted living facilities for moderate and low-income seniors and affordable housing options for frail and low-income seniors.

With the backdrop of the November election, Rhode Island lawmakers and Congress must continue their efforts to develop and implement programs and services especially geared to an aging society.

Aging as a policy and political issue will ultimately have an impact on every generation from today’s seniors, their aging baby boomers children, and finally to their young grandchildren and great-grandchildren.

Being an educated voter, especially one who consistently votes, is likely to gain points with a political candidate and with those who ultimately are elected to office.

Inaction on RIPAE Proposals Would Be a State Tragedy

Published in the Pawtucket Times on May 20, 2002

Lawmakers are rushing to finalize the state’s business, hoping to adjourn as early as the end of May.

With thousands of proposals in the legislative hopper, each representative was directed by House leadership to choose three of their own sponsored bills to push for in the Senate.

All legislative proposals that do not make the “priority” lists are as good as dead for the year.

At press time, one proposal, Pharmaceutical Assistance for the Elderly Program (RIPAE) moves closely to passage.

The House Finance Committee has put the proposal (H 7291) into the state budget article. Susan Sweet, a consultant and aging advocate said she expects full House passage of the state budget article by the end of the week.

Once passed by the House, the state budget article goes to the Senate for their consideration and approval. Sweet told All About Seniors that she believes that the Senate will quickly pass the budget, too.

With passage, the final state budget will be  forwarded to Governor Lincoln Almond.

Under H 7291, the state Department of Human Services would seek a waiver from the federal government, allowing Rhode Island to use Medicaid funding to pay for prescription drugs for low-income seniors with incomes up to $ 17,720 and couples with incomes up to $ 23,880.

The legislative proposal, authored by Lt. Governor Charles Fogarty and sponsored by Rep. Constantino and House Finance Chairman Gordon Fox, would enroll about 90 percent of the 37,000 seniors now enrolled in RIPAE. Because seniors would now qualify for prescription drug coverage under Medicaid all U.S. Food and Drug Administration (FDA) drugs would be covered not just those currently covered by RIPAE.

Seniors would pay a small copayment rather than the 40 percent co-payment currently charged.

With the passage of the state budget article, then “cleanup” begins on all legislative proposals, Sweet noted, adding that the two other RIPAE proposals have not been acted upon yet.

These legislative proposals would make prescription drugs more affordable to seniors and persons with disabilities who are not covered by the Medicaid waiver.

One bill (H 7290) would allow seniors enrolled in the RIPAE program to buy prescription drugs not currently covered by RIPAE at the discounted state price.

The other (H 7524) would allow low-income disabled persons on Social Security Disability Income who are between ages of 55 and 65 to become members of RIPAE and purchase prescription medications at the state discounted rate. Under booth, the state would be able to obtain the manufacturer’s rebate available through RIPAE.

Sweet along with other aging advocate groups, has called on the Rhode Island General Assembly to pass the three RIPAE proposals, which don’t cost the state one penny.

Not acting on them will continue a tragic trend that is well-documented in Rhode Island and nationwide.

That is, the high cost of prescription drugs forces many seniors on fixed incomes into not taking their prescribed medications at all or using only partial doses.

Moreover, noncompliance can lead to unnecessary hospitalization, nursing home admission and premature death.

Even in the shadow of a huge state budget deficit, lawmakers have the opportunity to lower the spiraling out-of-pocket costs of costs of prescription drugs, at no cost to the state.

The Ocean State is now posed to enact sound public policy that will result in no fiscal impact to state coffers.

If Congress is not ready to tackle this aging policy issue through the creation of a Medicare pharmaceutical benefit, then the Rhode Island General Assembly must take the lead and pass the three RIPAE proposals.

Simply put, it is the right thing to do on behalf of older and disabled constituents.