In the days of the Old West's outlaws, cattle rustlers and horse thieves, it was common practice for anyone condemned to be hanged to pay the hangman for his "services." I doubt if any hangings were postponed or canceled because of a failure to pay.
Regardless, I view such a practice to be as bizarre as if we were required to pay the Internal Revenue Service a fee for processing our tax returns. I consider it equally bizarre that hospitals and other healthcare providers were asked to pay Medicare a fee for processing, reviewing and auditing the obligatory year-end Medicare cost reports. Yet the Medicare cost report fee is exactly what the Clinton administration proposed in its federal budget for fiscal 1999, hoping to generate $395 million.
Fortunately, the House Appropriations HHS subcommittee excluded this "paying the hangman" item from its proposed legislation. I hope it will not emerge in the final budget. Hospital and health system executives need to remain watchful about this matter.
If the Clinton administration is still looking for revenues of this ilk, perhaps it should propose applying the "paying the hangman" idea to the Independent Counsel Act.