Going home again: Chances are slim for return-to-home legislation.

Chances are slim for return-to-home legislation

WITH CONGRESS BUSY PASSING APPROpriations bills, "maybe next year" may become the refrain from those interested in passing legislation to protect long term care residents in Medicare managed care plans.

The Seniors' Access to Continuing Care Act of 1999 (S 1142), introduced by Senator Barbara Mikulski (D-Md.), is pending in the Senate Committee on Health, Education, Labor and Pensions. The legislation, similar to a bin introduced in the last session, would ensure that seniors are able to return to their original continuing care community or skilled nursing facility after a trip to a hospital.

Currently, many managed care plans do not allow seniors to return home after hospitalization if the original long term care facility is not part of the managed care plan's provider network.

The Medicare Return to Home Act of 1999(S 1459), introduced by Senator Connie Mack (R-Fla.) is on hold in the Senate Finance Committee. The fact that Mack and three of the bill's five cosponsors are Republicans could work in its favor. However, "we are in a gridlock position right now" because of the impasse over the appropriations bills, says Mack's deputy press secretary, Bethany Rogers.

Mack's measure would ensure that seniors enrolled in Medicare+Choice health plans have the opportunity after hospitalization to return to a qualified residential community skilled nursing facility, provided the facility agrees to accept the payment that other similar facilities in its area accept.

Mikulski is "looking for a vehicle" to pull the measure forward, says spokesman Johanna Ramos-Boyer. Combining bills, often on different subjects, with a larger legislative proposal is a common way to advance them.

Ramos-Boyer acknowledges, however, that prospects for the bill are "slim." At press time in early October, Congress was behind schedule on passing major appropriations bills, and other measures are taking a back seat until the spending bills go through. Also, Mikulski and five of her bill's six cosponsors are Democrats, which cripples the bill's chances in the Republican-controlled Senate.

The American Association of Homes and Services for the Aging has been working with Mikulski's staff "for a couple of years now to get this kind of managed care consumer protection legislation passed," says AAHSA spokesman Robert Greenwood.

AAHSA also supports the Mack bill, Greenwood notes.