Concerns about geographical inequities in payment are legitimate and should be addressed. They were designed to pay for services covered by traditional Medicare, and plans have used extra funds to offer additional benefits, such as prescription drugs, eyeglasses, and dental services. Congress' goal should be to ensure that Medicare provides for the basic health care needs of seniors. Second, it is time to acknowledge that some BBA provisions designed to control rapid increases in Medicare spending were ill-advised. This Congress, in conjunction with the Administration, should take the requisite steps to amend these provisions.
Several areas demand our immediate attention.
As a result, we have seen sharp reductions in reimbursement to these institutions. It is time to look at the actual effects of the cuts, and where appropriate, make the necessary changes. Through BBA, Congress enacted a prospective payment system for SNF care that was designed to pay a federal per diem rate for covered services as of July 1, 1998. In the past year, nursing homes nationwide have struggled to navigate the transition to PPS using this system, and the transition has been arduous. The actual rate paid each facility includes a specific payment to account for the use of ancillary services.