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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

WASHINGTON : 1976

76-802

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

Washington, D.C. 20402 · Price $5.00

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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 D. HATHAWAY, Maine
FLOYD K. HASKELL, Colorado

(II)

76-603059

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251

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.---

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

utive vice president--

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

president-elect, accompanied by Nancy Fevold, acting executive director,

and Kenneth Williamson, consultant.--

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--

American Health Care Association, Bruce D. Thevenot, director, govern-

ment services division-----

American Hospital Association, John Alexander McMahon, president,

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

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

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

ment of legislation.--

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

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

American Society of Anesthesiologists, Dr. John W. Ditzler, president,

accompanied by Michael Scott, legal counsel---

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.----

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

Manufacturers

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

Medical Association, accompanied by Harry N. Peterson, director,

American Medical Association, department of legislation..
Bentsen, Hon. Lloyd, a U.S. Senator from the State of Texas.
Blue Cross Association, Bernard Tresnowski, vice president --

(IDI)

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329

Box 76

Bradley, John A., president, Federation of American Hospitals, accom

panied by Michael Bromberg, national director, and Albert C. Baker, Pago deputy director.-

132 Busbee, Hon. George D., Governor of the State of Georgia-

44 Cohelan, Jeffery, executive director, Group Health Association of America, Inc.

147 College of American Pathologists, Dr. Dennis B. Dorsey, president, accompanied by Dr. Jerald R. Schenken, and Dr. Vernie Stembridge---

279 Crowley, David C., executive vice president, American Association of Homes for the Aging-

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

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

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

237 Dorsey, Dr. Dennis B., president, College of American Pathologists, ac

companied by Dr. Jerald R. Schenken, and Dr. Vernie Stembridge---- 279, 291 Ecklund, Ms. Ruth B., president-elect, American Association of Nurse

Anesthetists, accompanied by Nancy Fevold, acting executive director, and Kenneth Williamson, consultant..

227 Federation of American Hospitals, John A. Bradley, president, accom.

panied by Michael Bromberg, national director, and Albert C. Baker, deputy director---

132 Fiorella, Beverly, president, American Society for Medical Technology,

accompanied by Nancy Preuss, immediate past president; L'Nora Wells, president-elect; and Dennis Weissman, director, office of government relations

262 Francois, Frank, vice president, National Association of Counties..

75 Group Health Association of America, Inc., Jeffery Cohelan, executive director

147 Health Insurance Association of America, William C. White, vice presi

dent, Prudential Insurance Co., accompanied by Fred J. Malley, Jr., vice president, Equitable Assurance Society

346 Hodes, Hon. Richard, chairman, Human Resources Task Force, National Conference of State Legislatures.-

63 Hughes, Frank, president-elect, National Retired Teachers Association

American Association of Retired Persons, accompanied by Laurence F.
Lane, legislative representative----

373 Kaiser Foundation Health Plan, Inc., James A. Lane, counsel

149 Lane, James A., counsel, Kaiser Foundation Health Plan, Inc.

149 MacDonald, Jack A., National Council of Health Care Services --

401 McMahon, John Alexander, president, American Hospital Association, accompanied by Leo J. Gehrig, M.D., senior vice president..

113 Moss, Hon. Frank E., a U.S. Senator from the State of Utah -

169 National Association of Blue Shield Plans, William E. Ryan, president.

356 National Association of Counties, Frank Francois, vice president

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

413 National Conference of State Legislatures, Hon. Richard S. Hodes, chairman, Human Resources Task Force -

63 National Council of Health Care Services, Jack A. MacDonald.-

401 National Retired Teachers Association-American Association of Retired

Persons, Frank Hughes, president-elect, accompanied by Laurence F.
Lane, legislative representative.

378 Nunn, Hon. Sam, a U.S. Senator from the State of Georgia -

283 Phillips, Charles D., president, American Protestant Hospital Association. 158 Ryan, William E., president, National Association of Blue Shield Plans-- 356 Seidman, Bert, director, department of social security, AFL-CIO, accom

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

251 Thevenot, Bruce D., director, government services division, American Health Care Association

386 Tresnowski, Bernard, vice president, Blue Cross Association

329

White, William C., vice president, Prudential Insurance Co., on behalf of

Health Insurance Association of America, accompanied by Fred J. Mal. Pago
ley, Jr., vice president, Equitable Life Assurance Society ----

346
Womer, Charles B., president, Yale-New Haven Hospital, on behalf of the

Association of American Medical Colleges, accompanied by Richard M.
Knapp, Ph.D., director, department of teaching hospitals, and John
A. D. Cooper, M.D., president.----

102
ADDITIONAL INFORMATION
Press release announcing these hearings---

1
Text of the bill S. 3205_.

2

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COMMUNICATIONS
Ambulance and Medical Services Association of America, Lynne Mahan,

executive secretary---
American Academy of Dermatology, Peyton E. Weary, M.D.-
American College of Nuclear Physicians, Jack K. Goodrich, M.D., presi-

dent
American Dental Association.---
American Enterprise Institute, John R. Virts, corporate staff economist,

Eli Lilly & Co.----
American Medicorp, Inc---
American Nurses' Association, Inc., Anne Zimmerman, R.N., president...
American Optometric Association --
American Osteopathic College of Pathologists, Inc., John A. Kline, D.O.,

president
American Osteopathic Hospital Association, Michael F. Doody, president.-
American Physical Therapy Association..
American Podiatry Association, John R. Graham, D.P.M., president.
American Protestant Hospital Association, Charles D. Phillips, president..
American Psychiatric Association ----
American Society of Internal Medicine_
American Society of Oral Surgeons...
American Speech and Hearing Association.-
Association for the Advancement of Psychology, Nicholas A. Cummings..
Bates, George N., president, Ohio State Medical Association --
Boston University Medical Center, University Hospital, James L. Dorsey,

administrator for fiscal affairs ---
Brock, Hon. Bill, a U.S. Senator from the State of Tennessee..
Burden, Carter, councilman, Manhattan, 7th District--
Burns, Chris, C.P.A., hospital financial consultant-----
Byrne, Hon. Brenuan, Governor of the State of New Jersey-
Caffrey, P. Rachael, M.D., president, Pathology and Cytology Laboratories,

Inc
California State Department of Health.
Catholic Hospital Association.---
Center on Social Welfare Policy and Law---
Chamber of Commerce of the United States, Rose P. Wooden, associate

director, economic security, education and manpower section.-
Community Service Society, Charles B. Dorf, chairman, committee on

health
Coopers & Lybrand
Council of Community Hospitals, John F. Horty, president..
Cummings, Nicholas A., Association for the Advancement of Psychology--
Doody, Michael F., president, American Osteopathic Hospital Association.-
Dorf, Charles B., chairman, committee on health, Community Service

Society
Dorsey, James L., administrator for fiscal affairs, Boston University

Medical Center, University Hospital.---
Ervin, Clinton V., Jr., M.D., Union of American Physicians.---
Goodrich, Jack K., M.D., president, American College of Nuclear

Physicians

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