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| Wilson Secures Key Medicare Reforms to Strengthen Health Care System in New Mexico |
September 26, 2000 |
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| Bill includes Wilson’s proposals to increase Medicare reimbursement rate in Albuquerque by more than 20% and allow New Mexico to keep nearly $35 million in unspent federal (SCHIP) child health care funds
WASHINGTON, DC –Congresswoman Heather Wilson has won a major battle to gain a critical Medicare reform provision in legislation pending before Congress and expected to pass prior to the end of the current legislative session. For months now, Wilson has been fighting to increase the Medicare reimbursement rate, which discriminates against New Mexico and other states like it and earlier today the House Commerce Committee approved legislation (H.R. 5291) that included her proposal to increase the minimum reimbursement rates.
The House leadership decided last week that the Medicare bill would originate in the powerful House Commerce Committee, on which the Congresswoman serves. Wilson has been working with the House leadership and Commerce Committee members to get provisions from the bipartisan bill she introduced earlier this year with Rep. Bill Luther (D-MN) incorporated into the draft bill.
“I’ve argued forcefully that we have to fix this discrimination first and shown what this is doing to reduce access to health care in New Mexico and rural areas across the country,” Wilson said.
Specifically, the bill includes Wilson’s provision to address the reimbursement inequities and instability in the Medicare Choice program by:
* Establishing a new Minimum Payment Floor of $525 a month per beneficiary in 2001 for all counties in Metropolitan Statistical Areas (MSA’s) with populations exceeding 250,000;
* Increasing the Payment Floor for Rural Areas by raising the minimum payment floor for all other counties from the current $415 to $475 in 2001;
“New Mexico is being discriminated against by the federal Medicare program. We need some immediate relief,” said Wilson. “With more than 40,000 seniors in New Mexico choosing Medicare HMO’s for their health care it is imperative that we correct the unfairness in the system that is threatening to drive HMOs out of the state. My proposal to increase the minimum reimbursement rate will ensure that seniors in New Mexico are treated fairly and have adequate choice in health care providers and I am very pleased that it has been included in the committee version of this bill.”
Earlier this year, the low reimbursement rates caused St. Joseph’s Hospital and other providers in New Mexico to announce that they were no longer going to offer HMO coverage to seniors on Medicare. According to Congresswoman Wilson, the current reimbursement rate of $430.44 in Albuquerque will jump to at least $525, an increase of more than 20%. And in rural parts of New Mexico, the rate will increase from $415 in most parts of the state to $475.
Additionally, the bill includes the following provisions that were also part of Wilson’s legislation:
* Increase the rate at which Medicare Choice reimbursement rates are allowed to grow from year to year;
* Allow New Mexico to keep 60% of the State Children’s Health Insurance Program (SCHIP) federal funds ($34.68 million) that they have not yet spent until 2002; and
* Changes federal law to permit Medicare Choice plans that announced their withdrawal in July 2000 to return to New Mexico in 2001.
“New Mexicans get their healthcare from a variety of providers. Reduced federal reimbursements for Medicare and Medicaid dependent citizens has significantly impacted these providers ability to provide quality healthcare to the state’s most needy,” said Wilson. “Coupled with federal restrictions in the SCHIP program (which handicaps New Mexico’s ability to offer health insurance to the state’s poorest children), these budget-deficit era policies are contributing to New Mexico’s healthcare crisis.”
The bill is expected to be voted on by the full House as early as next week. “This is only the first step,” said Wilson. “We’ve got to get the bill through the Congress and signed by the President and there are a lot of powerful states who have different priorities. But getting this through the Commerce Committee and in the base bill is a major victory.”
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