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American Institute of Certified Public Accountants :

Roscoe L. Egger, Jr., chairman, Federal Government Executive Com

mittee;

William Freitag, chairman, health care matters -
American Lung Association, William F. Roberts, acting managing director.
American Osteopathic College of Pathologists, Inc., Allan R. Fox, presi-

dent
American Osteopathic College of Radiology, Martin S. Landis, president--
American Osteopathic Hospital Association, Michael F. Doody, president.
American Physical Therapy Association, Robert A. Teckemeyer, associate

executive director professional relations-
American Society for Medical Technology-
American Society of Clinical Pathologists.
American Society of Internal Medicine, William P. Daines, M.D.
American Society of Oral Surgeons --
American Speech and Hearing Association.-
Association of Pathology Chairmen, Inc.-
Blue Shield Association---
California Medical Association.
Catholic Hospital Association.-
Caylor-Nickel Hospital, Inc., Charles H. Caylor, M.D., president--
Center on Social Welfare Policy and Law.-
Chamber of Commerce of the United States, Jan Peter Ozga.
Committee for a Federal Health Bank -
Crowley, David, executive vice president of the Association of Homes for

the Aging-
Daines, William P., M.D., American Society of Internal Medicine..
Doody, Michael F., president, American Osteopathic Hospital Association.-
Egger, Roscoe L., Jr., chairman, Federal Government executive committee,

American Institute of Certified Public Accountants---
Federal Trade Commission, Michael Pertschuk, chairman..
Fox, Allan R., president, American Osteopathic College of Pathologists.-
Freitag, William, chairman, health care matters, American Institute of

Certified Public Accounts --
Gaspar, Harold E., M.D., P.A.-
Goldbeck, Willis B., director, Washington Business Group on Health --
Hale, Randolph M., vice president and manager, Industrial Relations De-

partment, National Association of Manufacturers--
Hawaii Medical Service Association, Albert H. Yuen, executive vice presi-

dent
Health System Agency of Southwestern Pennsylvania, Matthew Marshall,

Jr., M.D., secretary, board of directors --
Homemakers Home and Health Care Services, Ronald E. Rosenberg, vice

president of planning and development.
Hospital Association of New York State
Hospital Financial Management Association.
Landis, Martin S., president, American Osteopathic College of Radiology--
Marshall, Matthew J., M.D., secretary, board of directors, Health System

Agency of Southwestern Pennsylvania.--
Massachusetts Eye and Ear Infirmary, Charles T. Wood, director.
National Association of Children's Hospitals and Related Institutions,

Robert H. Sweeney, executive director.--
National Association of Manufacturers, Industrial Relations Department,

Randolph M. Hale, vice president and manager.
Nightletter for American Medicine, Robert L. Weinmann, M.D., editor and

publisher
Ozga, Jan Peter, Chamber of Commerce of the United States -
Personnel Pool of America, Inc., John B. Smith, legal and legislative coun-

sel, Medical Personnel Pool Division.--
Public Citizen's Health Research Group--
Roberts, William F., acting managing director, American Lung Association.
Rosenberg, Ronald E., vice president of planning and development, Home-

makers Home and Health Care Services.
Schwartz, Ronald D.----
Scott, Michael, of Cox, Langford & Brown, counsel to ASA.

470 535 583

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546

547

552 555 562 476

547 563

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572

574 528

567 575 473

552 578 373

Servicemaster Industries, Inc., Kenneth T. Wessner, president and chief Page executive officer

580 Smith, John B., legal and legislative counsel, Medical Personnel Pool Division, Personnel Pool of America, Inc---

567 Sweeney, Robert H., executive director, National Association of Children's Hospitals and Related Institutions----

570 Teckemeyer, Robert A., associate executive director, professional relations, American Physical Therapy Association.

484 Washington Business Group on Health, Willis B. Goldbeck, director---- 583 Weinmann, Robert L., editor and publisher, Nightletter for American Medicine

574 Wessner, Kenneth T., president and chief executive officer, Servicemaster Industries, Inc.

580 Wood, Charles T., director, Massachusetts Eye and Ear Infirmary -

563 Yuen, Albert H., executive vice president, Hawaii Medical Service Association

546

APPENDIXES

449

588

Appendix A-Communications received by the committee expressing an in

terest in these hearings.-
Appendix B—Health Care Expenditures and Their Control, the Health

Staff, Education and Public Welfare Division, Congressional Research
Service, Library of Congress.

ADDITIONAL INFORMATION
Committee press release announcing these hearings..
Text of the bill, S. 1470--

1 3

MEDICARE AND MEDICAID ADMINISTRATION AND

REIMBURSEMENT REFORM ACT

TUESDAY, JUNE 7, 1977

U.S. SENATE,
SUBCOMMITTEE ON HEALTH OF THE

COMMITTEE ON FINANCE,

Washington, D.C. subcommittee met, pursuant to notice, at 8:35 a.m., in room 2221, Dirksen Senate Office Building, Hon. Herman E. Talmadge (chairman of the subcommittee) presiding.

Present: Senators Talmadge, Dole, and Danforth.

Senator TALMADGE. The subcommittee will come to order. Today, we begin 4 days of hearings on S. 1470, the Medicare and Medicaid Administrative and Reimbursement Reform Act. S. 1470, which I introduced joined by Senators Long, Ribicoff, Dole, and 16 other colleagues, is the successor proposal to S. 3205 of the last Congress. S. 3205 was the subject of 5 days of hearings last July.

[The committee press release announcing these hearings and the bill S. 1470 follows:1

(Press release, Committee on Finance, Subcommittee on Health)

FINANCE COMMITTEE ANNOUNCES HEARING ON MEDICARE AND MEDICAID

ADMINISTRATIVE AND REIMBURSEMENT REFORM Senator Herman E. Talmadge (D., Ga.), Chairman of the Subcommittee on Health of the Senate Finance Committee, announced today that the Subcommittee will hold a hearing in early June on the various Medicare and Medicaid administrative and reimbursement reform provisions of S. 1470, introduced by Senator Talmadge on May 5, is cosponsored by a total of 19 Senators.

The hearing will be held beginning at 8:30 a.m. each day beginning June 7 through June 10 in Room 2221, Dirksen Senate Office Building.

Senator Talmadge stated : “S. 1470 is an improved version of S. 3205, a similar proposal introduced in the last Congress. The present bill incorporates constructive testimony received last year during five days of hearings on S. 3205. S. 1470 is designed to deal with, among other things, the problem of the continued explosion in the costs of the Medicare-Medicaid programs. Last year, I pointed out that those programs would cost Federal and State taxpayers more than $38 billion in fiscal 1977. Bad as that was, just one year later these programs are estimated to cost Federal and State governments more than $47 billion in fiscal 1978.” Senator Talmadge said, with respect to soaring health costs: "The Congress and the Administration share a common concern; however, I believe we can best control costs by providing hospitals with equitable incentives and with the right kind of penalties."

Requests to testify.Senator Talmadge advised that witnesses desiring to testify during this hearing make their request to testify to Michael Stern, Staff Director, Committee on Finance, 2227 Dirksen Senate Office Building, Washington, D.C. 20510, not later than Friday, May 27, 1977. Witnesses will be notified as soon as possible after this date as to when they are scheduled to appear.

(1)

Once the witness has been advised of the date of his appearance, it will not be possible for this date to be changed. If for some reason the witness is unable to appear on the date scheduled, he may file a written statement for the record of the hearing in lieu of a personal appearance.

Consolidated testimony.-Senator Talmadge also stated that the Subcommittee urges all witnesses who have a common position or with the same general interest to consolidate their testimony and designate a single spokesman to present their common viewpoint orally to the Subcommittee. This procedure will enable the Subcommittee to receive a wider expression of views than it might otherwise obtain. Senator Talmadge urged very strongly that all witnesses exert a maximum effort to consolidate and coordinate their statements.

Legislative Reorganization Act.-In this respect he observed that the Legislative Reorganization Act of 1946, as amended, requires all witnesses appearing before the Committees of Congress "to file in advance written statements of their proposed testimony, and to limit their oral presentations to brief summaries of their argument."

Senator Talmadge stated that in light of this statute and in view of the large number of witnesses who have already formally requested an opportunity to appear before the Subcommittee in the limited time available for the hearing, all witnesses who are scheduled to testify must comply with the following rules :

(1) A copy of the statement must be filed by the close of business the day before the witness is scheduled to appear.

(2) All witnesses must include with their written statement a summary of the principal points included in the statement.

(3) The written statements must be typed on letter-size paper (not legal size) and at least 75 copies must be submitted before the beginning of the hearing.

(4) Witnesses are not to read their written statements to the Subcommittee, but are to confine their ten-minute oral presentations to a summary of the points included in the statement.

(5) Not more than ten minutes will be allowed for the oral summary. Witnesses who fail to comply with these rules will forfeit their privilege to testify.

Written statements.—Witnesses who are not scheduled for oral presentation, and others who desire to present their views to the Subcommittee, are urged to prepare a written statement for submission and inclusion in the printed record of the hearings. These written statements should be submitted to Michael Stern, Staff Director, Committee on Finance, Room 2227 Dirksen Senate Office Building not later than June 20, 1977.

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