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| Wilson hosts forum for seniors dropped by their HMO’s Medicare Program |
July 22, 2000 |
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| Albuquerque lawmaker announces proposed Medicare fix
Albuquerque, N.M. - Congresswoman Heather Wilson spoke today before an audience of hundreds of seniors worried about their healthcare and announced she would be introducing legislation next week that would bring relief to seniors in small states like New Mexico-states that face lower than average Medicare reimbursement rates.
“It’s important to remember that, no matter what, you will always have Medicare coverage,” Wilson told forum participants. “But it’s wrong and unfair that your decision to choose an HMO should be denied because arcane government rules and formulas devised decades ago treat New Mexicans unfairly. I’m introducing a bipartisan bill in the House next week that will fix that for New Mexico.”
The announcement came at a Wilson-sponsored forum for seniors affected by recent announcements that some Medicare providers are discontinuing their Medicare Choice program. Affected seniors-who will continue to have Medicare coverage-have until December 31, 2000 to find other healthcare options.
Wilson was the leader behind a House resolution (H.Res. 535) that passed overwhelmingly before the July 4 Congressional break. The resolution anticipated a significant increase in non-Social Security surpluses in the Congressional Budget Office mid-year re-estimates that were released last week and make adjustments to the Medicare program during this legislative session.
Wilson’s legislation, to be introduced in the House this coming week, addresses the issues raised by a lawsuit against the Medicare program that the State of New Mexico joined. It would:
* Increase the Medicare Choice reimbursement rates nationwide; and
* Create a way for counties that receive exceptionally low reimbursement rates to appeal or negotiate a higher rate when they can show that their costs exceed the reimbursed amount.
* Allow companies who have left Medicare Choice because the reimbursement rates are too low to come back without a waiting period.
Other provisions, including providing relief for home health care and shifting more rapidly to a national rate, are under development with principal co-sponsors and will likely be included in the bill.
The Federal lawsuit New Mexico joined was recently thrown out by a U.S. District Judge in Minnesota. Judge Donald Alsop ruled earlier this month that the system, though unfair, does not violate the Constitution. He suggested that the issue be resolved in Congress, not in the court system.
Health professionals have also cited low Medicare reimbursement rates as a key reason for a shortage of doctors in this state. Wilson says that’s not acceptable for New Mexicans who have every right to expect quality care. “We can have a Patients’ Bill of Rights, and we can provide a prescription drug benefit - and I have supported both - but that won’t be very important if seniors can’t find a health plan or a physician here willing to accept Medicare patients to provide care,” says Wilson.
“Our doctors and nurses are leaving New Mexico and our hospitals and HMOs are increasingly unable to provide the service seniors need and deserve. Today, I heard from hundreds of seniors who know just how serious this problem is. I’ve also heard from people who have “lost” their doctor to another state, and I have heard from physicians who have become one of three specialists in the state instead of one of fifteen. We need to fix this,” said Wilson. “I believe we need a way for counties that have very low reimbursement rates to show their actual costs and then appeal the Medicare Choice reimbursement or negotiate for a higher reimbursement.”
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.
Wilson has worked on this issue for a number of months, including efforts to provide Medicare reimbursement rate relief in the prescription drug bill recently passed in the U.S. House. That bill contained some relief for Medicare reimbursement rates, but Wilson felt that some of the most important changes would come too late to alleviate the crisis seniors in states like New Mexico are facing. “We need relief in New Mexico now - this year - not in 2002 or 2004,” Wilson said. “That’s what I’m fighting for.”
The federal government’s Health Care Financing Administration-which runs Medicare-participated in today’s forum at Wilson’s request. They presented information about options affected seniors have between now and December 31, when they will no longer be covered by their HMO Medicare program. Also participating in the forum were AARP, the New Mexico Agency on Aging, and the City of Albuquerque’s Department of Senior Affairs.
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