Hospitals may finally get to see some of their pet peeves over Medicare redressed in the near future. Two congressional leaders on healthcare issues fired off a letter listing more than 50 proposals for fixing Medicare to HHS Secretary Tommy Thompson last week, many of them torn from the pages of industry briefing books.
Reps. Nancy Johnson (R-Conn.), chairwoman of the House Ways and Means health subcommittee, and Fortney "Pete" Stark of California, the subcommittee's ranking Democrat, called for Thompson to act on their mixture of broad and program-specific recommendations "as quickly as possible."
"(The letter's ideas) absolutely came from the grass-roots level," said Mary Beth Savory Taylor, the American Hospital Association's vice president of executive branch relations. "These have been things that have been really frustrating our membership."
In addition to upgrading HCFA's 1970s-era accounting computer system, Johnson and Stark have asked for hospital wish-list improvements such as releasing regulatory notices once every six months instead of bombarding providers with an ongoing assault of program changes. The legislators also call for streamlining the hospital cost report and shortening the "Medicare as secondary payer" information requirements.
Other recommendations in the letter seek to resolve conflicts among the myriad rules facing acute-care facilities. For example, hospitals are financially responsible if they don't have patients complete an "advanced beneficiary notice" before receiving treatment, but it is illegal for hospitals to have emergency patients complete the form before they get care. Johnson and Stark recommend eliminating this requirement for emergency services.
This dilemma is "kind of a Catch-22 for hospitals," Savory Taylor said. "You are required to do this, but you may or may not get paid for it."
Reform of HCFA and its programs has been a hot topic during this session of Congress. The Ways and Means health subcommittee has held five hearings on Medicare modernization since January.
Thompson, fresh from a week at HCFA's headquarters in Baltimore, called the letter "a valuable contribution in compiling suggestions for modernizing Medicare."
Stark warned those at a press event touting the letter that changes wouldn't happen unless HCFA "gets the resources to carry out its job." President Bush has proposed a 4.9% increase in HCFA's program management budget to give the agency $2.35 billion for administration in fiscal 2002.
In a related development, Sen. Charles Grassley (R-Iowa), chairman of the Finance Committee, and Sen. Max Baucus of Montana, lead Democrat on the committee, has asked two federal offices for guidance in determining how to ease "the regulatory burden on Medicare providers without weakening antifraud tools." The offices are HHS' inspector general's office and the comptroller general in Congress' General Accounting Office.
Grassley and Baucus said they are concerned that bipartisan legislation to reduce Medicare hassles for providers would hamper the government's ability to pursue fraud in the $242 billion Medicare program.