Former CMS chief: Providers could face "very tough" year ahead

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The immediate past chief of the nation's Medicare and Medicaid programs said Thursday that long-term care providers should enjoy things now because next year could be rougher when it comes to funding.

"Next year will be a very tough year. You can look for a significant Medicare bill" to be pushed, said Thomas Scully, who was administrator for the Center for Medicare & Medicaid Services up until January. Now a private lobbyist and attorney for investors and other interests, Scully addressed about 1,200 people at the annual convention of the National Investment Center for the Seniors Housing and Care Industries (NIC) in Chicago.

Scully said an overriding concern will be "structural deficit problems" that could send whoever becomes president looking for funding take-backs. The biggest concern for long-term care providers, therefore, would be whether $1.5 billion in temporary funding add-ons for resource utilization groups (RUGs) will survive.

"It's the big thing hanging over heads for the next 18 months," Scully said. "Either administration could take it away tomorrow."

A self-described "mushy Republican" who worked in both Bush administrations, Scully said that a John Kerry victory in November would bring nursing home owners "tougher rhetoric" yet less of a push to cut Medicare funding. Another Bush administration, meanwhile, is likely to supply softer rhetoric, yet be filled with "budget hawks" looking to make cuts.

"In a 'bass-ackwards' way, a Kerry win may be good for the (nursing home) reimbursement picture," Scully said, reasoning that Republicans, who seem likely to have control of at least the House after the November elections would be more inclined to press for Medicare cutbacks.