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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.
IN THE SENATE OF THE UNITED STATES
MAY 5 (legislative day, APRIL 28), 1977
Mr. TALMADGE (for himself, Mr. LONG, Mr. RIBICOFF, Mr. DOLE, Mr. NUNN, Mr. EASTLAND, Mr. MATSUNAGA, Mr. RANDOLPHI, Mr. HOLLINGS, Mr. INOUYE, Mr. GRAVEL, Mr. FORD, Mr. JAVITS, Mr. PELL, Mr. PERCY, Mr. BROOKE, Mr. BURDICK, Mr. STONE, Mr. METZENBAUM, and Mr. HATHAWAY) introduced the following bill; which was read twice and referred to the Committee on Finance
To provide for the reform of the administrative and reimbursement procedures currently employed under the medicare and medicaid programs, and for other purposes.
1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 3 That this Act may be cited as the "Medicare-Medicaid
4 Administrative and Reimbursement Reform Act".
TABLE OF CONTENTS
HOSPITAL REIMBURSEMENT REFORM
Sec. 2. Criteria for determining reasonable cost of hospital services.
Sec. 4. Federal participation in hospital capital expenditures.
PRACTITIONER REIMBURSEMENT REFORMS
Sec. 10. Agreement by physicians to accept assignments.
Sec. 11. Criteria for determining reasonable charge for physicians' services.
Sec. 12. Hospital-associated physicians.
Sec. 13. Payment for certain antigens under part B of medicare.
Sec. 14. Payments on behalf of deceased individuals.
Sec. 15. Use of approved relative value schedules.
LONG-TERM CARE REFORMS
Sec. 20. Hospital providers of long-term care services.
Sec. 21. Reimbursement rates under medicaid for skilled nursing facilities and intermediate care facilities.
Sec. 22. Medicaid certification and approval of skilled nursing and intermediate care facilities.
Sec. 23. Visits away from institution by patients of skilled nursing or intermediate care facilities.
Sec. 30. Establishment of Health Care Financing Administration.
Sec. 32. Regulations of the Secretary.
Sec. 40. Procedure for determining reasonable cost and reasonable charge. Sec. 41. Ambulance service.
Sec. 42. Grants to regional pediatric pulmonary centers.
Sec. 43. Waiver of human experimentation provision for medicare and medicaid.
Sec. 44. Disclosure of aggregate payments to physicians.
Sec. 45. Resources of medicaid applicant to include property disposed of to applicant's relative.
Sec. 46. Rate of return on net equity for for-profit hospitals.
CRITERIA FOR DETERMINING REASONABLE COST OF
SEC. 2. (a) (1) The first sentence of section 1861 (v) 4 (1) (A) of the Social Security Act is amended by striking
5 out "The" and inserting "Subject to subsection (aa), the".
6 (2) Section 1861 (v) of the Act is also amended by 7 adding at the end the following paragraph:
"(8) For additional requirements applicable to deter
2 mination of reasonable cost for services provided by hos
3 pitals, see subsection (aa).".
(b) Section 1861 of the Act is amended by adding 5 after subsection (z) the following subsection:
"CRITERIA FOR DETERMINING REASONABLE COST OF
8 "(aa) (1) To more fairly and effectively determine 9 reasonable costs incurred in providing hospital services, the 10 Secretary shall, not later than April 1, 1978, after consult11 ing with appropriate national organizations, establish-
"(A) an accounting and uniform functional cost reporting system (including uniform procedures for allocation of costs) for determining operating and capital costs of hospitals providing services, and
"(B) a system of hospital classification under which hospitals furnishing services will initially be classified as follows:
"(i) by size, with each of the following groups of hospitals being classified in separate categories: (I) those having more than 5, but fewer than 25, beds, (II) those having more than 24, but fewer than 50, beds, (III) those having more than 49, but fewer than 100, beds, (IV) those having more than 99, but fewer than 200, beds, (V)
those having more than 199, but fewer than 300,
"(ii) by type of hospital, with (I) short-
"(iii) other criteria which the Secretary may find appropriate, including modification of bed-size categories;
but the system of hospital classification shall not differ
entiate between hospitals on the basis of ownership.
"(2) The term 'routine operating costs' used in this 24 subsection does not include:
"(A) capital and related costs,