Hospital groups said last week they had overcome last-minute objections from Congress to a plan to revamp the Medicare quality-certification program.
The measure is attached to an omnibus spending bill that would fund the federal government for the remainder of fiscal 1996, which began Oct. 1, 1995. That bill passed last week after Republican leaders and White House negotiators worked out last-minute concerns over several environmental issues.
Because Congress and the White House had been unable to agree on a balanced-budget blueprint for fiscal 1996, the government has been operating under a series of temporary spending measures.
The certification plan was developed by a coalition of hospital, long-term-care and other provider groups and was agreed to by HCFA officials. It would increase the interval between standard surveys for home health providers from a maximum of 15 months to 36 months.
The current year's budget for the survey and certification process is slightly less than $150 million. Increasing the length of time between surveys for home health providers wouldn't free up $8 million a year that could be used for initial certification of other providers, proponents of the plan claim.
In addition, the proposal would allow accreditation by HCFA-approved private-sector organizations to be accepted as certification for participation in the Medicare program and for follow-up surveys for certification of compliance with Medicare regulations.
Hospital groups say the changes are needed to alleviate a certification backlog that has occurred in 20 states.
"We have a lot of hospitals that have built new facilities, but they can't open them because they haven't been through the (certification) process; and that is happening all across the board," said Thomas Scully, president of the Federation of American Health System.
The final obstacle came last week from Sen. Tom Harkin (D-Iowa), the ranking Democrat on the Senate Appropriations health subcommittee. Harkin objected to the plan on the grounds it removed needed consumer protections.
But after intense lobbying by provider groups, Harkin relented.
"This is not a long-term solution, the issue is going to have to be looked at again," said Carla Luggiero, senior associate director of congressional relations at the American Hospital Association. "But for a short-term solution this is fine."