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Farance, surcanm the on Hearth
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 EM-
PLOYED UNDER THE MEDICARE AND MEDICAID PRO-

GRAMS, AND FOR OTHER PURPOSES

JUNE 7, 8, 9, AND 10, 1977

Printed for the use of the Committee on Finance

U.S. GOVERNMENT PRINTING OFFICE

WASHINGTON : 1977

92-202 0

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

Washington, D.C. 20402

KF 26 F5538 1977

COMMITTEE ON FINANCE

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

CARL T. CURTIS, Nebraska ABRAHAM RIBICOFF, Connecticut

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

ROBERT DOLE, Kansas GAYLORD NELSON, Wisconsin

BOB PACKWOOD, Oregon MIKE GRAVEL, Alaska

WILLIAM V. ROTH, JR., Delaware LLOYD BENTSEN, Texas

PAUL LAXALT, Nevada
WILLIAM D. HATHAWAY, Maine

JOHN C. DANFORTH, Missouri
FLOYD K. HASKELL, Colorado
SPARK M. MATSUNAGA, Hawaii
DANIEL PATRICK MOYNIHAN, New York

MICHAEL STERN, Staff Director
GEORGE W. PRITTS, Jr., Minority Counsel

SUBCOMMITTEE ON HEALTH

HERMAN E. TALMADGE, Georgia, Chairman ABRAHAM RIBICOFF, Connecticut

ROBERT DOLE, Kansas GAYLORD NELSON, Wisconsin

PAUL LAXALT, Nevada LLOYD BENTSEN, Texas

JOHN C. DANFORTH, Missouri SPARK M. MATSUNAGA, Hawaii

(II)

CONTENTS

ADMINISTRATION WITNESS

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

78

213
372

132

293

358

432

401

332

200

PUBLIC WITNESSES
AFL CIO, Bert Seidman, director, social security department, accompanied

by Robert McGlotten, legislative department, and Richard Shoemaker,

social security department---
Ament, Richard, M.D., president, American Society of Anesthesiologists.-
American Association for Comprehensive Health Planning, Anthony Mott,

chairman, legislative committee_
American Association of Neurological Surgeons, Donald H. Stewart, Jr.,

M.D
American Association of Nurse Anesthetists, Ruth E. Ecklund, president,

accompanied by Ronald F. Caulk, president-elect; J. Martin Stone, execu-

tive director; and Kenneth Williamson, Washington consultant--
American Association of Retired Persons, James M. Hacking, assistant leg-

islative counsel.---
American College of Nuclear Physicians, Richard C. Reba, M.D., presi-

dent, accompanied by John Dring and Kenneth L. Nicolas, executive

staff
American College of Radiology, Harold N. Schwinger, M.D., chairman,

board of chancellors, accompanied by Frederic D. Lake, M.D., president;
J. T. Rutherford, legislative counsel; and Otha W. Linton, director,

governmental affairs --
American Health Care Association, Bruce D. Thevenot, administrator, gov-

ernment services division.
American Hospital Association, John Alexander McMahon, president, ac-

companied by Alan Manzano, vice president and Leo J. Gehrig, M.D.,

senior vice president--
American Medical Association, Raymond T. Holden, M.D., chairman, board

of trustees, accompanied by Edgar T. Beddingfield, Jr., M.I 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

(DI)

139

228

197

409
372

205

156

403

126

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