Congress calls for Medicare reform following HCFA’s testimony

System is too complicated, say representatives

In a congressional hearing held late this summer, legislators heard testimony from representatives of the Health Care Financing Administra-tion (HCFA), Office of the Inspector General (OIG), and various physician provider and medical technology groups as to how the complex rules put forth by HCFA affect coverage issues and provider complaints.

At the hearing, "Medicare’s Management: Is HCFA’s Complexity Threatening Patient Access to Quality Care?" Rep. Michael Bilirakis (R-FL), chairman of the House Commerce Subcommittee on Health and the Environment, called for a new and improved HCFA and noted that many members of Congress, from both parties, question whether HCFA can efficiently administer a prescription drug benefit.

Ranking minority member Rep. Sherrod Brown (D-OH), defended HCFA and reminded those in attendance that the organization does not operate in a vacuum and that Congress and its leaders share the blame for any of HCFA’s problems.

HCFA hatches a plan for efficiency

Mike Hash, deputy administrator of HCFA, told the subcommittee of several recent HCFA initiatives designed to minimize Medicare regulations and strengthen the Medicare program’s efficiency and fiscal integrity. Specifically, those initiatives include:

- launching a wide-ranging education program to help providers understand Medicare policies and proper billing procedures, and preparing providers for new payment systems as mandated by law;


- revamping advance beneficiary notices by using "plain language" to make the document user-friendly so beneficiaries can make better informed choices;


- developing compliance programs for providers and inviting public comment on such guidance;

- requiring all claims-processing contractors to establish toll-free lines for providers to call with billing questions;

- simplifying evaluation and management guidelines designed to reduce the documentation for physicians to justify their claims;

- studying error rates at the contractor level so that HCFA can focus on education and error prevention;

- establishing the Physicians Regulatory Issues Team to ensure that HCFA addresses how its policies affect practicing physicians.

(This information is courtesy of the National Association for Home Care in Washington, DC.)