Page:United States Statutes at Large Volume 111 Part 3.djvu/658

 Ill STAT. 2746 CONCURRENT RESOLUTIONS-^JUNE 5, 1997 (3) the Congressional Budget Office reports that when the baby-boom generation begins to receive Social Security benefits and is eligible for Medicare in 2008, the Federal budget will face intense pressure, resulting in mounting deficits and erosion of future economic growth; (4) long-term solutions to address the financial and demographic problems of Medicare are urgently needed to preserve and protect the Medicare Trust Funds; (5) these solutions to address the financial and demographic problems of Medicare are urgently needed to preserve and protect the Medicare Trust Funds; (6) reform of the Medicare Program should ensure equity and fairness for all Medicare beneficiaries, and offer beneficiaries more choice of private health plans, to promote efficiency and enhance the quality of health care; (7) all Americans pay the same payroll tax of 2.9 percent to the Medicare Trust Funds, and they deserve the same choices and services regardless of where they retire; (8) however, under the currently adjusted-average-percapita cost (AAPCC), some counties receive 2.5 times more in Medicare reimbursements than others; (9) this inequity in Medicare reimbursement jeopardizes the quality of Medicare services of rural beneficiaries and penalizes the most efficient and effective Medicare service providers; (10) in some states, the result has been the absence of health care choices beyond traditional, fee-for-service medicine for Medicare beneficiaries, which in other counties and states plan providers may be significantly over-compensated, adding to Medicare's fiscal instability; and (11) ending the practice of basing payments to risk contract plans on local fee-for-service medical costs will help correct these inequities, mitigate unnecessary cost in the program, and begin the serious, long-term restructuring of Medicare. (b) SENSE OF THE SENATE. —It is the sense of the Senate that the provisions of this resolution assume that the Finance Committee should strongly consider the following elements for Medicare reform— (1) any Medicare reform package should include measures to address the inequity in Medicare reimbursement to risk contract plans; (2) Medicare should use a national update framework rather than local fee-for-service spending increases to determine the annual changes in risk plan payment rates; (3) an adequate minimum payment rate should be provided for health plans participating in Medicare risk contract programs; (4) the geographic variation in Medicare payment rates must be reduced over time to raise the lower payment areas closer to the average while taking into account actual differences in input costs that exist from region to regional; (5) Medicare managers in consultation with plan providers and patient advocates should pursue competitive bidding programs in communities where data indicate risk contract payments are substantially excessive and when plan choices would not diminish by such a bidding process; and

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