"Medicare insures America's older citizens, and the program should treat all of its recipients fairly. As it stands now, Iowa Medicare beneficiaries and health care providers are ending up with the short end of the stick. It's time to remove the barriers that keep older Iowans from fair treatment and access to health care services," Grassley said.
The Grassley amendments were made today to the comprehensive bill to fund Medicare and Medicaid which the Senate Finance Committee began considering on Tuesday morning. The first measure passed by a vote of 11 to 9. It provides an incentive for managed care plans to immediately begin making available services to Medicare beneficiaries in rural areas by replacing the Finance Committee Chairman's proposed $350 floor in the national Medicare formula used to reimburse providers for patient care with a floor of 85 percent of the national average. In Iowa, this would require a minimum reimbursement rate of $396.95 per person.
The second Grassley amendment passed by a vote of 11 to 9. It establishes that the wage data used to determine the Medicare reimbursement rate relies 100 percent upon the national average rather than 50 percent on the local average and 50 percent on the national average, as proposed by Finance Committee Chairman William Roth of Delaware.
Last week, during negotiations between Finance Committee members and the Chairman, Roth approved Grassley's proposal to establish a 50/50 national/local blended payment rate for managed care entities. This blending of rates is a key tool in improving payment to areas where medicare services are less costly such as Iowa.
Grassley said these changes are extremely important because Iowa ranks second lowest in the nation under the current Medicare reimbursement formula. In fact, every county in Iowa is reimbursed below the national average of $467 per person. For example, reimbursement rates are $252.12 per person in Allamakee County, $402.14 per person in Polk County, $410.93 per person in Pottawattamie County, $330.95 per person in Linn County, and $293.95 per person in Plymouth County. In sharp contrast, the rate per person in Richmond County, New York, is $767. In Miami, Florida, the rate is $748 per person.
"This terribly unfair payment system leaves older Iowans without benefits available to others, including eyeglasses, prescription medicine, hearing aids, and wellness programs. While it may be slightly less costly to provide some services in Iowa, the current rate is a gross distortion. Iowans should not be punished for providing high-quality services at a relatively low cost," Grassley said.
The provisions now included in the Finance Committee bill will help bring equity to the system so that those Medicare beneficiaries who want to select a managed care option can have access to it. "Older Americans should have access to the same options within Medicare regardless of where they live," Grassley said. The Finance Committee completed its work on the spending bill Wednesday afternoon. The proposal now must be approved by the full Senate and reconciled with the version advanced by the House of Representatives before it can be sent to the White House for the President's signature.
Grassley for many years has been a leader in Congress for improving access to rural health care. He is the third most senior member of the Finance Committee. In January, he was elected Chairman of the Senate Special Committee on Aging.