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| Budget deal pumps $34 million into New Mexico Healthcare |
December 16, 2000 |
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| “A wonderful Christmas present for New Mexico’s Seniors”
Albuquerque, NM-Congresswoman Heather Wilson today asked all three New Mexico healthcare providers to reconsider their decisions, made earlier this year, to scale back their participation in the federal Medicare Choice senior healthcare program. Wilson’s request comes in light of a Congressional budget deal that will increase reimbursement rates for those providers as they care for New Mexico seniors who prefer a managed care option.
“This is a wonderful Christmas present for New Mexico’s seniors,” said Wilson. “Senator Domenici and I have worked throughout the last year with our Democratic colleagues and health professionals in New Mexico to craft legislation that would bring needed relief to seniors in this state.”
Currently, more than 15,000 New Mexicans will be forced to find alternate healthcare arrangements at the end of this year. Wilson began working to end discrimination against New Mexico and a handful of other states in the federal reimbursement system early this year. Before this bill passed, the reimbursement rate for Bernalillo County was $430 per person per month and $415 per month in some other parts of the state - some of the lowest rates in the country and half what is paid in some other states.
The bill creates a national floor for Medicare Choice payments of $525 in urban areas like Albuquerque and $475 in the rest of the state. The bill also allows plans who announced they were leaving or scaling back effective January 1 to reconsider and stay.
“This is more than we could have ever realistically hoped to achieve,” continued the New Mexico lawmaker. “We believe that New Mexico’s seniors now have a great chance to keep the health care they have chosen, and look forward to hearing from each of the healthcare providers as they review the effects of the legislation we passed yesterday.”
“We don’t expect any business to operate in the red,” said Wilson to representatives of New Mexico healthcare providers that have lost money because of low reimbursement rates, leading them to scale back or withdraw from the federal program. “But the services you provide are a crucial component of our state’s healthcare system and seniors, many of them low-income New Mexicans, have come to rely on the flexibility and added benefits that managed care provides them.”
Presbyterian President and CEO Jim Hinton, Lovelace CEO Dr. Martin Hickey, and Janice Torrez, President of St. Joseph MedicarePlus joined Wilson and seniors today to celebrate the increased reimbursement rates passed yesterday by both chambers in Congress. That omnibus budget bill is now awaiting signature by the President.
“The President will sign this bill and it should allow many seniors to keep the health plan of their choice,” concluded Wilson.
Medicare Choice is the HMO component of Medicare, where participating HMO’s receive a fixed amount from the federal government for each enrolled patient. Medicare Choice reimbursement rates in New Mexico are among the lowest in the country. In New Mexico, the county with the highest reimbursement rate receives $430.44 per person per month for the Medicare Choice program. That compares with $719.23 in Texas, $729.07 in California, $794.02 in Florida, and $814.32 in New York.
As a result, three New Mexico health providers (St. Joseph’s, Presbyterian, and Lovelace) announced earlier this year that they would scale back their participation in the federal Medicare-HMO program, a decision based largely on these unfair federal reimbursement rates.
In October, Congressional negotiators agreed to increase the Medicare Choice Minimum Payment Floor to $525 a month per beneficiary in 2001 for all Metropolitan Statistical Areas (MSA’s) with populations exceeding 250,000. The health care providers in the Albuquerque MSA are currently reimbursed at $430 per beneficiary. Under the deal, the Albuquerque area would see an increase of $95 ($430 to $525) per beneficiary per month, resulting in at least an additional $34 million for New Mexico in FY2001.
In addition, the agreement would increase the Payment Floor for Rural Areas from the current $415 to $475 in 2001.
The final reimbursement rates are those proposed in bipartisan legislation introduced by both Domenici in the Senate and Wilson in the House earlier this year. In July, Domenici introduced the Medicare Geographic Fair Payment Act of 2000 (S.2937) to increase reimbursement rates and keep Medicare-HMO benefits available to at-risk seniors. Wilson, who introduced the Fair Care for Seniors Act (H.R.5001), was instrumental in gaining House Commerce Committee approval for a plan that increased Medicare Choice reimbursements to the $475 and $525 levels. A bill (HR.2614) that included Wilson`s Medicare Choice provisions passed in the U.S. House on Oct. 26, 2000 by a vote of 237-174.
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