And BIPA provisions allow a beneficiary to go beyond the administrative law judge to the Department of Appeals, which must hear the case within 90 days. Provider organizations claim the billions HMOs, hospitals, and other Medicare providers are getting as a result of the legislation will translate to additional access to services and benefits for beneficiaries, but consumer advocates say it s too early to tell. For three years, there have been widespread HMO withdrawals from Medicare. The money was intended to help prevent even more plans from leaving. Most of the extra funding HMOs get this year is going to HMO providers, not for additional benefits, admits the American Association of Health Plans.
Caution is the word when considering HMOs, according to beneficiary advocates.
Part of the money directed to nursing homes will be used to improve nursing staffing ratios. A lack of qualified nurses in skilled nursing facilities has led to a growing number of residents suffering from bedsores, malnutrition, and other health problems. The legislation also requires skilled nursing facilities to post nursing home staffing ratios, an important step in addressing the problem of inadequate staffing of the homes. All articles represent the viewpoints of the authors and are not necessarily those of the magazine or publisher. Entire contents 2001 by the National Committee to Preserve Social Security and Medicare.