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MEDICARE-MEDICAID ADMINISTRATIVE

AND REIMBURSEMENT REFORM

HEARINGS

BEFORE THE

SUBCOMMITTEE ON HEALTH

OF THE

COMMITTEE ON FINANCE
UNITED STATES SENATE

NINETY-FOURTH CONGRESS

SECOND SESSION

ON

S. 3205

A BILL TO PROVIDE FOR THE REFORM OF THE ADMINISTRATIVE AND REIMBURSEMENT PROCEDURES EMPLOYED UNDER THE MEDICARE AND MEDICAID PROGRAMS AND FOR OTHER

PURPOSES

JULY 26, 27, 28, 29, AND 30, 1976

Printed for the use of the Committee on Finance

U.S. GOVERNMENT PRINTING OFFICE

76-502

WASHINGTON : 1976

For sale by the Superintendent of Documents, U.S. Government Printing Office

Washington, D.C. 20402 · Price $5.00

COMMITTEE ON FINANCE

RUSSELL B. LONG, Louisiana, Chairman HERMAN E. TALMADGE, Georgia

CARL T. CURTIS, Nebraska VANCE HARTKE, Indiana

PAUL J. FANNIN, Arizona ABRAHAM RIBICOFF, Connecticut

CLIFFORD P. HANSEN, Wyoming HARRY F. BYRD, JR., Virginia

ROBERT DOLE, Kansas GAYLORD NELSON, Wisconsin

BOB PACKWOOD, Oregon WALTER F. MONDALE, Minnesota

WILLIAM V. ROTH, JR., Delaware
MIKE GRAVEL, Alaska

BILL BROCK, Tennessee
LLOYD BENTSEN, Texas
WILLIAM D. HATHAWAY, Maine
FLOYD K. HASKELL, Colorado

MICHAEL STERN, Staff Director
DONALD V. MOOREHEAD, Chief Minority Counsel

SUBCOMMITTEE ON HEALTH

HERMAN E. TALMADGE, Georgia, Chairman VANCE HARTKE, Indiana

ROBERT DOLE, Kansas ABRAHAM RIBICOFF, Connecticut

PAUL J. FANNIN, Arizona WALTER F. MONDALE, Minnesota

BOB PACKWOOD, Oregon
MIKE GRAVEL, Alaska

BILL BROCK, Tennessee
WILLIAM HATHAWAY, Maine
FLOYD K. HASKELL, Colorado

(II)

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CONTENTS

ADMINISTRATION WITNESSES
Ahart, Gregory J., Director, Human Resources Division, General Account-

ing Office, accompanied by Robert E. Iffert, Jr., Assistant Director, and Page
Robert Hughes, Assistant Director...

91

Mathews, Hon. David, Secretary, Department of Health, Education, and

Welfare, accompanied by Dr. Theodore Cooper, Assistant Secretary for

Health ; Dr. Stuart Altman, Deputy Assistant Secretary for Planning

and Evaluation/Health; J. Bruce Cardwell, Commissioner of Social

Security; Thomas Tierney, Director, Bureau of Health Insurance,

Social Security Administration; and Dr. M. Keith Weikel, Commis-

sioner, Medical Services Administration, Social and Rehabilitation

Service

29

PUBLIC WITNESSES

AFL-CIO, Bert Seidman, director, department of social security, accom-

panied by Robert McLaughtan, legislative representative, AFL-CIO,
and Richard Shoemacher, assistant director, Department of Social
Security, AFL-CIO---

251

American Association of Homes for the Aging, David C. Crowley, exec-

utive vice president--

408

American Association of Nurse Anesthetists, Ms. Ruth B. Ecklund,

president-elect, accompanied by Nancy Fevold, acting executive director,
and Kenneth Williamson, consultant.---

227
American College of Radiology, Dr. John Dennis, president, accompanied

by Dr. Frederic D. Lake, chairman, board of chancellors and Otha W.
W. Linton, director, governmental relations--

217
American Health Care Association, Bruce D. Thevenot, director, govern-
ment services division---

386

American Hospital Association, John Alexander McMahon, president,

accompanied by Leo J. Gehrig, M.D., senior vice president -

113

American Medical Association, Dr. Edward Beddingfield, chairman, coun-

cil on legislation, accompanied by Harry N. Peterson, director, depart-

ment of legislation --

190

American Protestant Hospital Association. Charles D. Phillips, president-- 158

American Society for Medical Technology, Beverly Fiorella, president,

accompanied by Nancy Preuss, immediate past president; L'Nora Wells,

president-elect; and Dennis Weissman, director, office of government

relations

262

American Society of Anesthesiologists, Dr. John W. Ditzler, president,
accompanied by Michael Scott, legal counsel.-

237

Association of American Medical Colleges, Charles B. Womer, president,

Yale-New Haven Hospital, accompanied by Richard M. Knapp, Ph. D.,

director, department of teaching hospitals, and John A. D. Cooper,

M.D., president..

102

Ballard, Brenda, director, employee benefits, National Association of

Manufacturers

413

Beddingfield, Dr. Edward, chairman, council on legislation, American

Medical Association, accompanied by Harry N. Peterson, director,
American Medical Association, department of legislation..

190
Bentsen, Hon. Lloyd, a U.S. Senator from the State of Texas..

213
Blue Cross Association, Bernard Tresnowski, vice president--

329

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