HCFA last week approved the first private-sector, fee-for-service plan for Medicare beneficiaries. The plan will be offered by Sterling Life Insurance Co. and will mostly be available to Medicare beneficiaries in rural areas who haven't been able to enroll in Medicare+Choice managed-care plans. The Sterling Life plan is approved for operations in 17 states as of July 1. The Balanced Budget Act of 1997 authorized the creation of private, fee-for-service Medicare plans.
President Clinton's proposal to add basic prescription drug coverage to the Medicare benefit package would cost $79 billion over five years, the Congressional Budget Office reported last week. That's nearly twice what Congress has set aside for a drug benefit and other Medicare reforms during the same period. Over 10 years, the Clinton plan for a basic drug benefit would cost $160 billion, the CBO said. The cost of the total Clinton plan actually would exceed the CBO's estimates, which don't include "catastrophic" coverage. Clinton has proposed setting aside $35 billion for 10 years of catastrophic coverage; an alternative Democratic proposal would devote $50 billion in the same period to catastrophic coverage.
Separately, Clinton last week expressed concern over delays in reaching a compromise managed-care reform bill and has urged the House-Senate conference committee charged with the task to hurry. The committee missed a mid-April deadline.
The Senate Appropriations Committee last week voted to cut off some funding of a U.S. Justice Department lawsuit against tobacco companies in an effort to forestall the lawsuit. Tobacco-state senators, several of whom sit on the appropriations committee, are strongly opposed to the Justice lawsuit. The Department of Agriculture funding bill would repeal a provision in current law allowing HHS and the Departments of Defense and Veterans Affairs to help fund the lawsuit, which seeks to recoup from cigarette makers the costs of treating smoking-related illnesses.
The American Nurses Association is supporting ergonomic standards proposed by the Occupational Safety and Health Administration. ANA President Mary Foley told the U.S. Labor Department at a hearing in Washington last week that the proposal would help prevent back injuries among nurses who work in hospitals. The American Hospital Association opposes the standards, which aim to prevent worker injuries by requiring hospitals to install patient-lifting devices. The AHA says that OSHA's proposal, which would cost providers millions of dollars, lacks scientific support.
HCFA last week released proposed national criteria for covering new healthcare items or services under Medicare. Any new item or service would have to produce a better outcome than current medical practice, according to the proposed criteria. It would have to add value by substituting a less-invasive treatment for surgery, for instance, or substituting a less-expensive treatment. The new criteria will be published in a proposed rule in the May 16 Federal Register. The comment period will be 30 days.
Three congressmen introduced legislation last week that would create a federal system for conducting criminal background checks of nursing home workers. Most states require homes to screen potential and current workers, but the federal government does not. Reps. Jim Talent (R-Mo.), Chris Cannon (R-Utah) and Mike Thompson (D-Calif.) introduced a bill that would require homes to check national crime databases at no cost to the homes. Homes that knowingly hire a person who fails the background check would pay a fine of up to $5,000. The American Health Care Association, which represents nursing homes, supports the measure.