Every American deserves access to high quality, affordable
health care. But, despite the wealth of our nation, many Americans are
denied that access. Today, 44 million Americans, 10 million of whom are
children, have absolutely no health insurance. Another 190 million, who
enrolled in managed care plans, are often unable to receive the treatment
prescribed for them by their physicians because they lack basic patient
rights. And, 14 million senior citizens, who were promised that Medicare
would take care of them in their golden years, do not have coverage for
the prescription medications they need to stay healthy.
In 1997, Congress created the Children's Health Insurance Program (CHIP),
which represented the largest investment in children's health care since
the inception of Medicaid in 1965. Our major challenge now, is to move
beyond the successes of CHIP in covering kids to increase the number of
adults with access to health care. We must also establish Patients' Bill
of Rights so that doctors, not insurance company bureaucrats, make medical
decisions governing care for patients who have coverage. And, we must update
Medicare to include an affordable, voluntary prescription drug benefit
for our nation's seniors.
On December 20, the Senate passed S.1864, the Nurse Reinvestment Act, by
UC. The base language for the bill was derived from the Kerry-Jeffords
bill of the same title (S. 706 - the modified version of which (S. 1597)
was passed by the Senate HELP Committee on November 11).
The legislation also incorporated elements of S.721, introduced by Hutchinson-Mikulski.
Lead sponsors S.1864 were Kerry, Jeffords, Hutchinson and Mikulski. The
House companion of S.706 also passed in December. The two versions must
now be reconciled in conference. Support for the Nurse Reinvestment Act
is broad - nursing associations, hospital, nursing home, hospice associations,
labor, colleges/universities, etc.
The Nurse Reinvestment Act supports the recruitment of new nursing students
through public service announcements and career partnerships between health
care facilities and schools. The bill also establishes a fast?track faculty
development program to ensure there are professors to teach the students
we recruit. The bill provides educational support for students who need
help getting-up to speed on math, science and medical English, and daycare
and transportation for single moms and dads with children who need a hand.
The Nurse Reinvestment Act reinvests in nurses who are already practicing
by providing education and training at every step of the career ladder.
Our bill also helps colleges and universities develop curriculum in gerontology
and long-term care to prepare nurses to treat our aging population. Finally,
the bill authorizes, for the first time in history, a National Nurse Service
Corps to administer scholarships to students who commit to working in a
health care facility or area that is experiencing a shortage of nurses.
During the Finance Committee mark-up of the Economic Recovery and Assistance
for American Workers Act on November 8, a Kerry-Rockefeller Amendment to increase
the
FMAP was accepted by the Chairman, and passed out of committee. The amendment
increased the federal Medicaid matching rate by 1.5% for all states and 3% for
high unemployment states, ensuring that adequate funding existed to provide serious
fiscal relief to states that support health coverage for low-income Americans
during the recession. No further Senate action has yet occurred on the economic
stimulus package, however.
On July 19, JK sent a letter to the President, for which he secured the signatures
of 58 of his Senate colleagues, urging Bush to allow federal funding for embryonic
stem cell research. On July 20, Senator Specter held a press conference (JK was
in Boston) to highlight the Kerry letter and majority Senate support for stem
cell research. In August, President Bush announced his decision to allow the
use of federal funds to conduct studies only on existing stem cell lines. Federal
funds would be prohibited from being used for the creation or destruction of
new embryos as sources of cells. Thus, Bush adopted a restricted version of the
stem cell research policy Kerry had advocated.
During the first session of the 107th Congress, JK introduced several health
care bills which were poised for Senate consideration, but ultimately not acted
upon prior to adjournment. A few of these bills are likely to be considered
in the second session.
>>Medicare Appeals, Regulatory and Contracting Improvements Act (MARCIA)
Last March, JK joined Senator Murkowski in introducing the Medicare Education
and Regulatory Fairness Act (MERFA), a bill to reform CMS regulation of Medicare
providers. The bill was reintroduced as MARCIA (S.1738) in November, with Senators
Baucus and Grassley joining JK and Murkowski as lead sponsors. Prior to adjournment,
MARCIA companion legislation was passed in the House.
MARCIA has five primary components. First, it relieves burdens on beneficiaries
and providers by requiring the Centers for Medicare and Medicaid Services (CMS)
to issue rules and policies in an orderly and reasonable manner. Second, it
provides appeals protections for all Medicare fee-for-service providers and
beneficiaries. Third, it allows CMS to use competition to select the best available
administrative contractors to serve beneficiaries and providers. Fourth, it
requires Medicare contractors and CMS to place a greater emphasis on provider
education and outreach. Finally, it makes the Medicare overpayment collection
and extrapolation process more fair. The bill accomplishes all of these objectives
without undermining the False Claims Act or other Medicare fraud recovery efforts,
and I urge my colleagues to join with me to secure its passage.
>>S.1686, Safe Nursing and Patient Care Act of 2001
This bill improves working conditions for nurses and, in turn, the quality of
care they are able to provide patients. It limits the ability of hospitals and
other health care providers to require nurses to work mandatory overtime. The
restrictions are enforced through Medicare's provider agreements.
>>S. 1304, Medicare coverage of oral phosphate-binding drugs for kidney dialysis
patients. Patients with end-stage renal disease (ESRD) cannot eliminate dietary
phosphorus and, without a kidney transplant, often develop hyperphosphatemia.
This condition - and the hospitalization that accompanies it - can be prevented
through the use of phosphate-binding drugs, which reduce the absorption of phosphorus
in the body. Medicare coverage of phosphate binders makes both medical and economical
sense. Not only does the medication improve the quality of life for patients
with kidney failure, but it stands to reduce overall Medicare costs associated
with treating hyperphosphatemia.
>>S. 1303, The Kidney Patient Daily Dialysis Quality Act of 2001. This bill
will update the Medicare program's dialysis coverage policy by eliminating the
limitation on the number of sessions now covered by Medicare. Specifically,
this bill will move Medicare beyond its conventional coverage of three dialysis
sessions per week to provide coverage of more frequent dialysis - as defined
by at least five times a week at a dialysis facility or in the home - if determined
appropriate by a patient's physician. More frequent dialysis stands to save
the Medicare program between $120 million and $620 million per year.
>>S. 841, The Medicare Mental Illness Non-Discrimination Act. This bill will
repeal the 50% copayment for outpatient mental health services and replace it
with the standard 20% copayment for which all other outpatient services are
assessed. Under the current system, if a Medicare patient sees an endocrinologist
for diabetes treatment, an oncologist for cancer treatment, a cardiologist for
heart disease treatment or an internist for treatment of the flu, the co-payment
is 20% of the cost of the visit. If, however, a Medicare patient visits a psychiatrist
for treatment of mental illness, the co-payment is 50% of the cost of the visit.
This disparity in outpatient co-payments represents discrimination against Medicare
beneficiaries with mental illness.
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