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Health Care

Medicare Prescription Drugs

Seniors should never have to choose between prescription drugs in their medicine cabinet and food on their table.  We made significant progress when I worked together with members of Congress and the President to pass the Medicare prescription drug bill.  Today all 150,000 Montana seniors and disabled individuals are able to sign up for comprehensive drug coverage on a voluntary basis for a modest monthly premium ($22 on average in 2007).  For individuals making less than about $13,500 a year, the drug coverage is stronger still.  Roughly 45,000 to 50,000 Montana seniors may be eligible to have co-payments as little as $1 and $3.  They also have no or low monthly premiums, no or reduced deductibles, and no gaps in coverage.  It's not a perfect benefit, but it's a solid start.

Improvements to Medicare

This year, I helped write and pass H.R. 6331, the Medicare Improvements for Patients and Providers Act which became law on July 15th with overwhelming support in both the House and Senate from Republicans and Democrats.  My bill blocked a cut in physician payments for Medicare services this year and raised payments next year, extended an increase in the payment for physicians in rural areas, eliminated penalties for late enrollment in the Medicare drug benefit for low-income seniors and established a demonstration project to allow states to test new ways to better coordinate hospital, nursing home, home health and other critical health care services in rural areas.  It also included a provision that would strengthen rural hospitals’ ability to provide emergency mental health care services for veterans in crisis in rural areas. This provision was based on the bill I in June, the Relief for Rural Veterans in Crisis Act of 2008. Senator Jon Tester was a co-sponsor of that bill.
           
Key provision of the Medicare bill that help Montana:

  • Blocked a cut in physician payments for Medicare services this year and raised payments next year.
  • Expanded rural hospitals’ ability to provide emergency mental health care services for veterans in crisis in rural areas.
  • Extended an increase in the payment for physicians that work in rural areas.
  • Extended rules allowing independent laboratories to bill Medicare directly.
  • Enlisted Social Security to help low-income seniors apply for the Medicare Savings Program, so more who qualify get assistance.
  • Eliminated penalties for late enrollment in the drug benefit for low-income seniors.
  • Exempted the value of life insurance policies or assistance provided by churches and family members from the asset test for the low-income subsidy program  in the Medicare drug benefit.
  • Provide $25 million to State Health Insurance Assistance Programs (SHIPs) and Area Agencies on Aging to help enroll low-income seniors in the Medicare Savings Program and the low-income subsidy for the Medicare drug benefit, and to help all seniors better navigate Medicare.
  • Require the use of more recent data to better reimburse sole community hospitals – the only hospital within 35 miles
  • Establish a demonstration project to allow states to test new ways to better coordinate hospital, nursing home, home health and other critical health care services in rural areas.
  • Require prescription drug plans (in the Medicare Part D Program) to promptly repay pharmacists.
  • Increase payment for primary care services in shortage areas, corrects a reduction applied to physician work, and adds new funding and authority for the Medical Home Demonstration Project.
  • Reduce beneficiary out-of-pocket spending for mental health services to match other outpatient medical care.
  • Extend the exceptions process for seniors receiving therapy services beyond current limits.
  • Allow speech pathologists to bill Medicare directly for services.
  • Improve payments and coverage for patients with chronic obstructive pulmonary disease (COPD) and other conditions, including reforms to oxygen payments.
  • Increase payment for ambulance services in both urban and rural areas.
  • Ensure that critical access hospitals – small hospitals serving large rural areas – are properly paid for clinical lab services provided to Medicare beneficiaries.
  • Expand the sites at which beneficiaries are eligible to receive telehealth services in rural areas.
  • Increase Medicare payments to community health centers.