WASHINGTON – First District Congressman Paul Ryan today confirmed that an important provision he had been fighting for which is critical to protecting area nursing homes has been included in Medicare refinement legislation which is expected to come before the House of Representatives for a vote this week. Ryan has been working with other legislators in pushing to include this measure – which protects county nursing homes from a Clinton Administration regulation that would have resulted in a sudden funding shortfall – in the bill. This provision relates to the Intergovernmental Transfer Program, commonly referred to as IGT. The legislation also includes provisions he has advocated that assist disproportionate share hospitals (DSHs) and raise the "floor" – the lowest reimbursement level for Medicare + Choice providers.

"Without this legislation, county nursing homes like Rock County Health Care Center in Janesville and the seniors they serve would be facing a crisis," said Ryan. "I'm very happy that Congress has moved this bill forward with protections for county facilities. We're trying to stop the Administration from putting an extremely harmful regulation into effect that would strip much-needed funding from our county nursing homes."

The overall legislative package would increase Medicare payments to health care providers including hospitals and nursing homes. The bill includes the following specific provisions, which Ryan has been fighting for:

• It protects Wisconsin's county-owned nursing homes, which presently benefit from funding transfers made possible by the Intergovernmental Transfer Program (IGT). Since 1985, federal regulations have allowed Wisconsin to claim deficits in operating costs by nursing homes that are administered by the counties or other local units of government for purposes of receiving federal dollars through the Medical Assistance program. However, the Health Care Financing Administration (HCFA) issued a proposed rule that would change the way the state claims losses in operating costs by nursing homes. In fact, the state fiscal bureau estimates that the proposed regulation could result in a loss to Wisconsin of as much as $67.6 million in federal matching funds in 2000-2001. This would result in funding cuts to county nursing facilities. The House Medicare bill includes a provision championed by Congressman Ryan that prevents HCFA from modifying current regulations for two years.

• The bill also includes inflationary updates for all DSH hospitals and an increase for low DSH states such as Wisconsin.

• In addition, the bill sets the Medicare + Choice minimum floor payments at $475 per person per month for rural areas and $525 for urban areas. Currently, the floor is approximately $400 in rural areas of Southern Wisconsin –  below the break-even point for area Medicare + Choice providers.

"Another very important part of this bill raises the 'floor' reimbursement level for Medicare + Choice providers," said Ryan. "This is a positive step in the right direction, but I am very troubled by White House obstruction on critical Medicare + Choice reforms," Ryan added. "In negotiations with Congress about this bill, the President has opposed crucial reforms that would give Wisconsin Medicare + Choice providers a fairer reimbursement rate. Southern Wisconsin's low reimbursement rates have already driven some Medicare + Choice providers to leave the area or increase premiums. Medicare relief isn't a partisan issue, and House Republicans have been working with congressional Democrats to bring forward this significant legislative package, yet the President is opposing our efforts to equalize Medicare payments for Wisconsin seniors."

Because southern Wisconsin's reimbursement rates are very low compared to those that apply in other states such as Florida and New York, southern Wisconsin's seniors enrolled in Medicare + Choice plans often do not share the same level of benefits as seniors in other states. For this reason, Congressman Ryan cosponsored H.R. 406, the Medicare Fair Payment Act, which would equalize payments to Medicare + Choice providers nationwide and make the system much fairer for Wisconsin seniors. Earlier this year, this provision was included in the House-passed prescription drug legislation. Unfortunately, the President threatened a veto of this bill, which stopped any further action.