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Senator vows to reform Medicare if effort to save HMO benefits fails

December 02, 1999|By LAURA ERNDE

Congress has taken action to try to prevent Washington County senior citizens from losing their Medicare HMO benefits at the end of the year, Sen. Barbara Mikulski said Thursday.

If the effort fails, Mikulski, D-Md., said she'll work for Medicare reform next year in the hopes of getting prescription drug benefits for all senior citizens.

"I think it's a national mandate," she said.

Included in the Balanced Budget Refinement Act of 1999 signed this week by President Clinton were financial incentives for HMOs to enter or stay in rural areas, she said.

CareFirst BlueCross BlueShield is ending its managed-care program in Washington County and 16 other rural Maryland counties Dec. 31 because reimbursements from the federal government didn't cover their costs.

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Mikulski said she worked to offer HMOs a 5 percent increase in the federal reimbursement to encourage them to enter or stay in those areas.

CareFirst hasn't decided whether that will be enough for them to stay, she said.

Mikulski had hoped to give one HMO an exclusive, long-term contract in the state to serve a multi-county area that doesn't have any Medicare HMOs. But that attempt failed.

If CareFirst rejects the incentive, senior citizens will not lose health-care coverage. They will be placed into a traditional Medicare plan and are being encouraged to buy supplemental Medicap coverage for hospitalization.

The recently passed legislation also increases Medicare payments to nursing homes for patients who need more expensive and complicated care and delays cuts for home health services, she said.

"I think what we did here is stop the hemorrhaging," she said.

Mikulski held a town hall meeting Thursday at the Fahrney-Keedy Senior Center near Boonsboro.

There, she outlined the Democratic agenda for senior citizens when Congress reconvenes in January.

Medicare was created in 1964 to help people pay for prolonged hospital stays. Today, hospital stays are shorter, but there's more need for managing chronic conditions through medications and physical and occupational therapy, she said.

"Medicare must make the transition. We're going to provide a safety net for people with chronic conditions," she said.

Medicare cuts made in 1997 went far deeper than Congress intended and Mikulski wants to restore funding without hurting taxpayers.

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