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CONGRESSMAN ROBERT A. UNDERWOOD Delegate from Guam U.S. House of Representatives Washington, D.C.

NEWS RELEASE July 12, 2001


Congressman Robert A. Underwood today said a notice for the application of a Cost-of-Living adjustment for Medicare reimbursement rates for Guam's home healthcare providers was published July 5 in the Federal Register.

Prior to last year, the COLA adjustment for Medicare reimbursement did not apply to Guam, although it did apply in Alaska, Hawai‘i, the Virgin Islands and Puerto Rico. At the request of Guam's home healthcare providers, who serve some 600 homebound seniors and disabled people, Congressman Underwood asked the U.S. Department of Health's Health Care Financing Administration (HCFA) why the Medicare reimbursement rate was lowered from 96% to 65%, beginning in Fiscal Year 2000. (The lower rate meant a significant reduction in the amount Medicare paid to healthcare providers for patient care.)

In looking into the matter, HCFA discovered that the rate reduction had been based on inaccurate information and should not have occurred. HCFA also discovered that Guam was not receiving a COLA adjustment, which also affected the Medicare reimbursement rate. In March 2000, HCFA restored the reimbursement rate to 96% and applied a COLA rate of 1.225, retroactive to October 1, 1999. The July 5, 2001 rule establishes as policy the application of the Medicare COLA adjustment for Guam.

The notice states, "We inadvertently published these [previous] notices without a COLA for the Territory of Guam because we did not include COLA factors for Guam in the per-visit tables in the applicable notices. The COLA factor for Guam should have been 1.225 in each of these notices."

"This is situation typifies the need for my 'Insular Areas Oversight Avoidance Act' and the particularly crucial need to keep Guam on federal radar screens when policies are being considered," the Congressman said. "HCFA readily acknowledged the oversight when we brought it to their attention, but we shouldn't have to look over every federal shoulder to make sure we're not forgotten or left out.

"I'm grateful to the Health Care Financing Administration for remedying the situation, both in the short and long run. Under the Clinton Administration HCFA acknowledged the oversight and provided a remedy, and under the Bush Administration, formalized that remedy," he added.

For additional information, contact: Cathy Gault at 671-477-4272

Washington office: 2418 Rayburn Office Building Washington, D.C. 20515 Tel: 202-225-1188 Fax: 202-226-0341 Email: 

Guam office: 120 Fr. Duenas Ave., Ste 107 Hagatna, GU 96932 Tel: 671-477-4272 Fax: 671-477-2587 

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