A House subcommittee wouldn't make good on some of President Clinton's healthcare promises last week as it passed legislation to fund HHS.
The House Appropriations Committee's HHS panel has approved legislation that doesn't include the White House's proposal to fund selected HCFA functions by levying $659.2 million in fees on providers.
The bill also doesn't include money for another Clinton healthcare proposal: $900 million over the next five years to encourage Medicaid enrollment of the 3 million children eligible but not enrolled. Clinton's budget, for the fiscal year beginning Oct. 1, called for that money to come from an increase in tax revenues under a tobacco-control bill, which is not likely to pass this year.
A GOP Appropriations Committee aide said the committee does not have the authority to earmark any funds for those programs without the consent of the committees that authorize those programs.
The Medicaid outreach money would require authorization from the House Commerce Committee, while the HCFA user-fee revenue money would require authorization from the House Ways and Means Committee.
In Clinton's budget, the biggest provider fee would have been $395 million worth of charges next year on hospitals and other Part A providers, such as skilled-nursing facilities, submitting year-end cost reports that claim the government owes them money. In those cases, HCFA would have charged providers a fee for their settlements, review or audits, which in turn would be used to finance an increased number of HCFA audits of providers, with the aim of detecting and deterring inflated or fraudulent cost reports.
The proposal would have doubled the number of audits and reviews conducted by HCFA in fiscal 1999. In 1997 HCFA audited the cost reports of 4,964 of the 37,995 providers subject to such audits and reviewed 83 million of the 842 million claims processed by Medicare.
The full Appropriations Committee, meanwhile, approved language that would affect other federal fraud-busting functions. It approved a U.S. Justice Department appropriations bill that would require the General Accounting Office to monitor and report on the Justice Department's implementation of guidelines on the use of the False Claims Act in healthcare fraud investigations (June 8, p.4).
In total, the HHS legislation passed last week by the HHS subcommittee provides $34.1 billion for the department's programs. It is one of 13 bills Congress must pass to fund government operations in federal fiscal 1999.
The full Appropriations Committee is not scheduled to consider the legislation until after Congress returns from its Independence Day recess. The Senate Appropriations Committee's HHS panel will draft its version of the legislation on July 7, and the full committee is scheduled to consider it July 9.