House passes budget act, to providers' dismay

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The House's passage of the Deficit Reduction Act this week drew concerns from the long-term care community, which is opposed to the bill's hard line on asset transfers, as well as therapy for seniors.


The bill, which cuts Medicaid by $4.8 billion and Medicare by $6.4 billion over five years, has been in limbo since late December when the Senate passed the measure by a tiebreaking vote. Because of small changes to the bill, it was thrown back to the House, which passed the bill Wednesday 216 to 214. President Bush is expected to sign the bill into law.

The legislation's punitive stance towards asset transfers troubles nursing home providers. The bill would change the lookback period for transferring asset transfers to qualify for Medicaid nursing home care to five years from three. It also would change the penalty phase for improper asset transfers to coincide with a nursing home stay. Both measures would increase the burden of uncompensated care on long-term care providers, according to the American Health Care Association. That would leave the nursing facility, and not the state, to collect from individuals who have no private funds and are not Medicaid eligible.

Another problematic aspect of the bill for providers is its enactment of the Medicare therapy caps in January. But providers are also relieved that the bill includes an exceptions policy to allow those beneficiaries who need services above and beyond the cap to receive them. AHCA said it would continue to monitor this issue — the exceptions procedures have not been devised, yet alone enacted, yet — throughout the year.