News in brief - Nov. 6, 2000

Medicare premiums rise

Seniors will see monthly Medicare Part B premiums increase about 10% beginning January 2001, the Dept. of Health and Human Services announced.

The monthly premium next year will be $50 -- a $4.50 increase from 2000. Officials said the boost was necessary to cover higher costs and legislative changes. In recent years, the premium has remained relatively stable. No increase occurred in 2000 or in 1998; a $1.50 bump occurred in 1999.

Further congressional oversight of the Health Care Financing Administration is needed to ensure that Medicare's regulations comply with existing laws, a congressional task force concluded in an October report.

The Task Force on Healthcare, which the House Budget Committee created to focus on the waste that results from Medicare's regulatory burden, pointed out examples of Medicare regulations that HCFA enacted without following rule-making requirements.

One such regulation requires physicians or licensed independent practitioners to see patients face-to-face within one hour of the application of restraints or use of seclusion. "This regulation appeared without any apparent analysis by HCFA of alternative ways to meet the rule's purposes," according to the report.

The Small Business Administration evaluated the one-hour rule at the task force's request. It found that the agency had a statutory duty to assess the regulation's impact on small rural hospitals and to consider less burdensome alternatives. Failure to do that analysis puts HCFA in violation of federal law, the SBA said.

The task force also recommended that HCFA consider ways to strengthen its measurement of improper Medicare and Medicaid payments.

The Health Care Financing Administration cut the number of inappropriate Medicare payments to independent clinical and physician laboratories, but room for improvement still exists, the Office of Inspector General reported last month.

HCFA overpaid the laboratories about $31.2 million for chemistry, hematology and urinalysis tests between July 1, 1995, and Dec. 31, 1997. That's an improvement over the $50.2 million in overpayments that the OIG found in the two-year period that ended June 30, 1995.

The OIG said that carriers lack adequate procedures and controls to detect and prevent inappropriate lab test payments. The agency recommended that HCFA work with carriers to ensure that their computer software can appropriately identify which laboratory service codes can and cannot be billed to Medicare.

Enrollment in Medicaid increased by 1.1 million in 1999, reflecting growth in 43 states plus the District of Columbia, according to new Kaiser Family Foundation data.

The trend toward increased Medicaid enrollment has developed since the second half of 1998, according to survey findings. This helped to reverse enrollment declines in the health insurance program for low-income individuals that occurred between 1996 and 1998.

Increased enrollment in public programs like Medicaid and the State Children's Health Insurance Program was a driving force in the drop in the number of uninsured Americans the U.S. Census Bureau reported recently. Taken together, Medicaid and SCHIP enrollment increased by more than 1.7 million individuals in 1999, compared with 1998, according to the Kaiser survey and U.S. Census data.

A second Kaiser study revealed that the majority of states had made it easier for children to retain Medicaid and SCHIP coverage by dropping asset tests, eliminating face-to-face interviews and requiring only annual reviews of eligibility.

A bill to create a bipartisan congressional commission to study a range of privacy issues, including medical record privacy, died during Congress' waning days. The bill's co-sponsor, Rep. Asa Hutchinson (R, Ark.), said he would reintroduce the measure in the next Congress.

The legislation would have designated $5 million for the appointment of a bipartisan, 17-member commission to embark on an 18-month study of financial and health privacy issues that have surfaced during the current computer-driven age.

Although the bill had a range of supporters, including physicians, managed care companies, the hi-tech industry and health insurers, it lacked the additional 14 congressional votes needed for passage.