"They need additional Medicare payments to get up and running."

But many have cut back benefits, saying Medicare payments were still far too low.

The office said Medicare payments for nursing care were $12.2 billion in 1997.

Medicare payments to hospitals are based on such cost reports.

Medicare payments to doctors and hospitals would be cut up to 2 percent.

She said Medicare payments to the company increased more than $30 million in 1990, the year after the extra charges began.

For a doctor's initial visit with a hospital patient, the Medicare payment would be $94, up from the current $77.

Medicare payments to doctors have risen more than 15 percent a year in the 1980's.

Another proposal would set a ceiling on Medicare payments for each state.

In addition, the law significantly increases Medicare payments to private health plans.