Blues representatives were working late last week to change a federal lobbying law that could keep Blue Cross and Blue Shield plans from negotiating new contracts as Medicare fiscal intermediaries.
With negotiations for fiscal 1997 contracts scheduled to begin in March, the Blues plans were on a tight deadline, but their last-second efforts appeared to bear fruit. Buried deep in a House-passed measure to keep the federal government open was language the Blues plans said would solve their problem. The Senate was expected to follow suit.
The problem stemmed from a complaint made by Sen. Alan Simpson (R-Wyo.), who said the American Association of Retired Persons, which receives federal grants, was using its resources to support heavyhanded lobbying of lawmakers. Congress later passed a bill that barred groups carrying a federal tax status designed for social welfare organizations from receiving federal grants.
The original bill was supposed to affect only a limited number of groups receiving grants. However, lawmakers added a provision at the last minute that broadened the measure to include any group receiving federal contract money.
That change brought the Blues plans, which routinely lobby Congress, under the bill's jurisdiction and necessitated last week's 11th-hour lobbying effort. Last year, Blues plans were paid $1.3 billion by Medicare to administer more than 90% of Medicare Part A claims and nearly 70% of Part B claims (See related story, p. 6).
The Blues' successful lobbying effort came despite a budget stalemate that has stalled most new legislation in Congress.
"With everything going on in Congress with the budget, it is hard to get them to focus on this," said Brenda Larsen Becker, executive director of congressional communications at the Blue Cross and Blue Shield Association. "They want to fix this, but they also don't want to open up these bills to all kinds of changes."
If the changes cannot be made, HCFA has told the Blues that it will not begin negotiations in March for next year's fiscal intermediary contracts, which are tied to the federal fiscal year that begins Oct. 1.
Some groups affected by the bill have set up separate subsidiaries that accept federal funds, a move being considered by the Blues. However, because of the Blues' complicated structure of for-profit, not-for profit, indemnity and managed-care organizations, that may not be possible.