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MEDICARE-MEDICAID ADMINISTRATIVE AND REIMBURSEMENT REFORM ACT

HEARINGS

BEFORE THE

SUBCOMMITTEE ON HEALTH

OF THE

COMMITTEE ON FINANCE
UNITED STATES SENATE

NINETY-FIFTH CONGRESS

FIRST SESSION

ON

S. 1470

TO PROVIDE FOR THE REFORM OF THE ADMINISTRATIVE AND REIMBURSEMENT PROCEDURES CURRENTLY EMPLOYED UNDER THE MEDICARE AND MEDICAID PROGRAMS, AND FOR OTHER PURPOSES

92-202 O

JUNE 7, 8, 9, AND 10, 1977

Printed for the use of the Committee on Finance

U.S. GOVERNMENT PRINTING OFFICE

WASHINGTON: 1977

For sale by the Superintendent of Documents, U.S. Government Printing Office Washington, D.C. 20402

[blocks in formation]

CONTENTS

ADMINISTRATION WITNESS

Califano, Hon. Joseph A., Jr., Secretary, Department of Health, Education, Page
and Welfare___

78

PUBLIC WITNESSES

293

432

American Medical Association, Raymond T. Holden, M.D., chairman, board
of trustees, accompanied by Edgar T. Beddingfield, Jr., M.D., chairman,
council on legislation__.

American Protestant Hospital Association, Charles D. Phillips, Ed. D.,

president

American Psychiatric Association, Dave M. Davis, M.D., immediate past
president, Georgia Psychiatric Association, director of psychiatric serv-
ices, Peachtree-Parkwood Mental Health Center and Hospitals, Atlanta,
Ga

American Society of Anesthesiologists, Richard Ament, M.D., president__

Asmus, Harry, president, National Council of Health Care Services, accom-

panied by Jack MacDonald, executive vice president_.

Association of American Medical Colleges, John A. D. Cooper, M.D., presi-
dent, accompanied by David D. Thompson, M.D., director, New York Hos-
pital, and chairman, Council of Teaching Hospitals, and James D. Bent-
ley, Ph. D., assistant director, Department of Teaching Hospitals----

Association of American Physicians and Surgeons, Thomas G. Dorrity,

M.D., director, accompanied by Maurice A. Kramer, assistant executive

director, Washington office----

Association of State and Territorial Health Officials, Dr. Robert P.
Whalen

228

409

156

126

Blue Cross Association, Neil Hollander, vice president for health care serv-
ices
Bromberg, Michael D., director, national offices, Federation of American
Hospitals, accompanied by Robert J. Samsel, president_--_.
College of American Pathologists, Tyra Hutchens, M.D., president-elect and
chairman, Department of Clinical Pathology, University of Oregon Medi-
cal School, accompanied by Dr. Jerald R. Schenken, Nebraska Methodist
Hospital

Congress of Neurological Surgeons, Donald H. Stewart, Jr., M.D___
Cooper, John A. D., M.D., president, Association of American Medical Col-
leges, accompanied by David D. Thompson, M.D., director, New York Hos-
pital, and chairman, Council of Teaching Hospitals and James D. Bent-
ley, Ph. D., Assistant Director, Department of Teaching Hospitals______
Davis, A. B., Jr., executive vice president and chairman, Board of Directors,
Kansas Hospital Association, accompanied by Frank L. Gentry, execu-
tive director, Kansas Hospital Association__.
Davis, Dave M., M.D., immediate past president, Georgia Psychiatric Asso-
ciation, director of Psychiatric Services, Peachtree-Parkwood Mental
Health Center and Hospitals, Atlanta, Ga., on behalf of the American
Psychiatric Association and the National Association of Private Psychi-
atric Hospitals__.

Dorrity, Thomas G., M.D., director, Association of American Physicians and
Surgeons, accompanied by Maurice A. Kramer, assistant executive direc-
tor, Washington office__

Ecklund, Ruth E., president, American Association of Nurse Anesthetists,
accompanied by Ronald F. Caulk, president-elect; J. Martin Stone, execu-
tive director; and Kenneth Williamson, Washington consultant______
Federation of American Hospitals, Michael D. Bromberg, director, Na-
tional Offices, accompanied by Robert J. Samsel, president_.
Filer, John H., chairman and chief executive officer, Aetna Life and Cas-
ualty, on behalf of the Insurance Association of Connecticut, accom-
panied by Burton E. Burton, senior vice president, group division,
Aetna

Finger Lakes Health Systems Agency, Anthony Mott, executive director__
Greene, Tom E., III, vice president, Paine, Webber, Jackson & Curtis, Inc.,
on behalf of Hospital Financing Study Group__.
Hacking, James M., assistant legislative counsel, National Retired Teach-
ers Association and American Association of Retired Persons----
Hansen, Jacqueline, board chairman, Health Systems Agency, Kansas
City

Health Insurance Association of America, Morton D. Miller, vice chairman,
Equitable Life Assurance Society of the United States, accompanied by
William C. White, Jr., vice president, Prudential Insurance Co. of
America

Health Systems Agency, Kansas City, Jacqueline Hansen, board chair

man

Holden, Raymond T., M.D., chairman, Board of Trustees, American Medical Association, accompanied by Edgar T. Beddingfield, Jr., M.D., chairman, council on legislation____.

Page

252

170

341

293

156

264

409

403

358

170

398

132

289

432

132

280

132

228

252

Hollander, Neil, vice president for Health Care Services, the Blue Cross
Association

Hollister, Hon. David, on behalf of the National Conference of State
Legislatures

115

Horty, John F., president, National Council of Community Hospitals, accompanied by John Huff, counsel__.

186

Hospital Financing Study Group, Tom E. Greene III, vice president, Paine,
Webber, Jackson & Curtis___.

289

Hutchens, Tyra, M.D., president-elect, College of American Pathologists
and chairman, Department of Clinical Pathology, University of Oregon
Medical School, accompanied by Dr. Jerald R. Schenken, Nebraska
Methodist Hospital.--

341

Insurance Association of Connecticut, John H. Filer, chairman and chief
executive officer, Aetna Life and Casualty, accompanied by Burton E.
Burton, senior vice president, group division, Aetna__
Kansas Hospital Association, A. B. Davis, Jr., executive vice president and
chairman, board of directors, accompanied by Frank L. Gentry, execu-
tive director_-_-_

Levetan, Liane, commissioner, De Kalb County, Ga., and member, Health
and Education Policy Steering Committee of the National Association of
Counties, accompanied by Mike Gennell, legislative representative_-__
McMahon, John Alexander, president, American Hospital Association, ac-
companied by Alan Manzano, vice president and Leo J. Gehrig, M.D.,
senior vice president----

Miller, Morton D., vice chairman, Equitable Life Assurance Society of the
United States, accompanied by William C. White, Jr., vice president,
Prudential Insurance Co. of America, on behalf of Health Insurance
Association of America____

Moran, M. Gail, staff director, Committee on Human Resources, National
Governors' Conference--.

Mott, Anthony, executive director, Finger Lakes Health Systems Agency,
and chairman, Legislative Committee, American Association for Compre-
hensive Health Planning----

Murphy, Richard E., legislative director, Service Employees International
Union, accompanied by Stanley Wisniewski, research director, Service
Employees International Union__

National Association of Counties, Liane Levetan, commissioner, De Kalb
County, Ga., and member, Health and Education Policy Steering Com-
mittee, accompanied by Mike Gennell, legislative representative_-_
National Association of Private Psychiatric Hospitals, Dave M. Davis,
M.D., immediate past president, Georgia Psychiatric Association, direc-
tor of psychiatric services, Peachtree-Parkwood Mental Center and
Hospitals, Atlanta, Ga_____

National Conference of State Legislatures, Hon. David Hollister___. National Council of Community Hospitals, John F. Horty, president, accompanied by John Huff, counsel.

Page

398

264

307

139

280

317

132

272

307

409

115

186

National Council of Health Care Services, Harry Asmus, president, ac-
companied by Jack MacDonald, executive vice president____
National Governors Conference, M. Gail Moran, staff director, committee
on human resources_

205

317

National Retired Teachers Association, James M. Hacking, assistant legislative counsel

432

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

Reba, Richard C., M.D., president, American College of Nuclear Physi-
cians, accompanied by John Dring; and Kenneth L. Nicolas, executive
staff

Schwinger, Harold N., M.D., chairman, Board of Chancellors, American
College of Radiology, accompanied by Fredric D. Lake, M.D., president;
J. T. Rutherford, legislative counsel; and Otha W. Linton, director,
governmental relations

Seidman, Bert, director, Social Security Department, AFL-CIO, accom-
panied by Robert McGlotten, Legislative Department, and Richard Shoe-
maker, Social Security Department--
Service Employees International Union, Richard E. Murphy, legislative
director; accompanied by Stanley Wisniewski, research director___.
Stewart, Donald H., M.D., American Association of Neurological Surgeons_
Thevenot, Bruce D., administrator, Government Services Division, Ameri-
can Health Care Association___.

197

401

332

213

272

293

200

Whalen, Dr. Robert P., on behalf of the Association of State and Territorial
Health Officials

126

COMMUNICATIONS

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

452

American College of Emergency Physicians--
American Dental Association_.

463

465

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