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July 1981

Volume 44, Number 7

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The Social Security Bulletin is the official monthly publication of

the Social Security Administration. Calendar-year data for each year

1939-48 were published in the Social Security Yearbooks and, begin-

ning with data for 1949, in the Annual Statistical Supplements to the

Bulletin. (The Supplements with data for each year 1949-54 were in-

cluded in the September Bulletin, 1950-55; beginning with 1955 data,

the Supplement is a separate publication.) Statements in Bulletin arti-

cles do not necessarily reflect official policies of the Social Security

Administration.

The Bulletin is prepared in the Office of Research and Statistics, Of-

fice of Policy, Social Security Administration, under the general
supervision of Robert Robinson, Chief of the Publications Staff, and
the editorial supervision of Marilyn Thomas. Suggestions or com-
ments concerning the Bulletin should be addressed to the Office of Re-
search and Statistics.

The Social Security Bulletin is for sale by the Superintendent of
Documents, U.S. Government Printing Office, Washington, D.C.
20402. A copy of the Supplement is included in the annual subscrip-
tion price of the Bulletin.

Price: $16.00 a year in the United States and $20.00 in all other
countries; single copies, $2.50 domestic and $3.15 foreign. Price of the
1977-79 Supplement is $4.50 domestic and $5.65 foreign.

U.S. DEPARTMENT OF HEALTH

AND HUMAN SERVICES
Richard S. Schweiker, Secretary
SOCIAL SECURITY ADMINISTRATION
John A. Svahn, Commissioner

OFFICE OF POLICY

Lawrence H. Thompson, Associate Commissioner

OFFICE OF RESEARCH AND STATISTICS
John J. Carroll, Director

HE 3.3:44/7

HD
7/23
A34

Social Security in Review

Benefit Changes Under the Medicare

and Medicaid Programs

The Omnibus Reconciliation Act of 1980, enacted as Public Law 96-499 on December 5, 1980, contains more than 50 provisions relating to Medicare and Medicaid and is expected to have a greater impact on those programs than any other single piece of legislation since the 1972 Amendments to the Social Security Act. The following benefit changes go into effect on July 1:

-Section 930 provides for coverage under Medicare of unlimited home health visits. It also eliminates the 3-day prior-hospitalization requirement for home health services under the hospital insurance program (Part A of Medicare) and the $60 deductible for home health services under the supplementary medical insurance program (Part B), includes occupational therapy under the qualifying criteria for home health benefits, and permits proprietary home health agencies to participate in States not having licensure laws. -Section 933 recognizes comprehensive outpatient rehabilitation facilities as Medicare providers and authorizes reimbursement under the program for rehabilitation services provided in certified outpatient rehabilitation facilities.

-Section 936 expands coverage under Medicare to include those services provided by dentists that would be covered under current law when provided by physicians. The provision also covers hospital stays for a noncovered dental procedure when the condition is of sufficient severity.

-Section 937 provides Medicare coverage of optometrists for the treatment of aphakia. It also requires that the Secretary of Health and Human Services submit legislative recommendations to Congress by January 1, 1982, for coverage of optometric services in connection with cataracts and other services authorized under licensure.

-Section 939 eliminates the exclusion from Medicare coverage of plantar warts.

-Section 965 mandates the coverage of the nursemidwife services that such practitioners are authorized to perform under State law. The new law stipulates that the effective date of this provision is the calendar quarter beginning more than 120 days after enactment, which is the calendar quarter beginning July 1.

523

The following benefit changes went into effect at an
earlier date:

-Section 932 provides full reimbursement under
Medicare for diagnostic services performed in a hos-
pital's outpatient department and, to the extent prac-
tical (as determined by the Secretary), in a physician's
office within 7 days before the patient's admission as
an inpatient. This provision became effective upon
enactment of the law.

-Section 938 covers under Medicare antigens pre-
pared by one physician and forwarded to another for
administering to a patient. This provision took effect
on January 1.

-Section 945 permits the enrollment of Medicare
beneficiaries in Part B at any time, with entitlement
beginning 3 calendar months after the month of en-
rollment, and authorizes unlimited reenrollment in
Part B and in Part A for those purchasing that protec-
tion. The provision became effective on April 1.

-Section 945 also permits States without Part B buy-
in agreements to obtain them and authorizes States
with buy-in agreements covering only cash assistance
recipients to cover other Medicaid eligibles. This pro-
vision is effective during calendar year 1981 only.
-Section 954 provides that a person with a legal obli-
gation to pay a physician's bill for a deceased benefi-
ciary may be reimbursed by Medicare, even for unas-
signed claims, before payment of the bill. Formerly,
the physician's bill had to be paid before Medicare
would reimburse for unassigned claims. This provi-
sion became effective with claims filed on or after
January 1, 1981.

-Section 956 requires the Secretary to make payment
under the Medicare hospital insurance program for
inpatient hospital or skilled-nursing facility services in
those instances where a beneficiary requiring a higher
level of care is erroneously placed in a part of the in-
stitution providing a lower level of care. This provi-
sion became effective on January 1, 1981.

An additional change, contained in section 935, increases the annual limit for outpatient physical therapy services under Medicare from $100 to $500. This provibrera sion will affect expenses incurred in calendar year 1982 and later.

Social Security Bulletin, July 1981/Vol. 44, No. 7

AUG 7 1981

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DEPOSITED BY THE

UNITED STATES OF AMERICA

Cross-National Study

of Income Maintenance

"Most other countries are far more generous than the United States to families with children-particularly those in modest circumstances. Only the existence of food stamps and the earned income tax credit keep the U.S. from lagging still further behind other countries in meeting the economic needs of such families."

These were among the key findings of a 2-year, eightcountry study of income maintenance from a family policy perspective conducted by Alfred J. Kahn and Sheila B. Kamerman of Columbia University's School of Social Work. The co-directors announced the results of their research on April 28-30 at a reporting conference in Washington, D.C., attended by nearly 100 government officials and representatives of national organizations and research centers.

The researchers studied 15 hypothetical family types and applied the program rules in effect in Australia, Canada, England, the Federal Republic of Germany, France, Israel, Sweden, and the United States during the period 1979-80 to determine benefits. In all eight countries, per capita income as a proportion of the net average wages of production workers was lowest for two-parent families with one wage earner, who was unemployed. Not much better off were one-parent families in which the parent, a woman, did not work-despite the fact that such families are a protected type in all the nations studied. Funding for the study, except for the Australian research, was provided by the Office of Research and Statistics of the Social Security Administration.

The study was designed to compare the annual income of each hypothetical family type-made up of government transfer payments and wages after payment of taxes-with that of an average worker in that country, and to determine which government policies most affected income. In end-of-year income of all family types in the eight countries, the United States typically ranked eighth if the families lived in a State with average maximum payments under the aid to families with dependent children (AFDC) program-such as Pennsylvania-and typically ranked sixth if they lived in a State with more generous AFDC payments-such as New York. According to the study directors, the low rankings resulted largely from the lack of an American program to provide child or family allowances, benefits that are available in all the other nations studied.

"Despite the existence of what might be considered generous income-maintenance programs in the eight countries, wages and the number of earners in a family are what make the most difference in family income," said the researchers. "Government income transfers and tax policies, however, also provide important help for families, especially for low- and middle-income families with children."

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At the end of March 1981, the old-age, survivors, and disability insurance (OASDI) program was paying $10.8 billion in monthly cash benefits to more than 35.8 million beneficiaries-an increase of $1.7 billion in the amount of monthly benefits and 610,000 in the number of beneficiaries since March 1980. The OASI program accounted for 91 percent of the rise in the total amount of monthly benefits and 100 percent of the growth in the number of beneficiaries.

During the 12-month period ending in March 1981, the monthly amount of OASI benefits rose 19 percent, and the number of beneficiaries increased 2 percent. The amount of DI benefits rose 14 percent despite a 2percent decrease in the number of beneficiaries.

Average monthly benefit amounts payable in March 1981 showed no significant changes from those for February. They were, however, considerably higher than the March 1980 averages due to the 14.3-percent costof-living increase that became payable in July. The average benefit amount was $343.47 for retired workers and $371.26 for disabled workers, compared with $295.33 and $322.63 a year earlier.

In March 1981, monthly benefit awards numbered 387,352, 16 percent more than the February 1981 total and 2 percent less than the number awarded a year earlier. Eighty-six percent, or 334,051, of these awards were immediately payable. The average monthly amounts of the currently payable awards were $330.76 and $388.39 for retired and disabled workers, respectively.

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