Johns Hopkins Hospital, Robert M. Heyssel, M.D., letter.. Johns, Varner J., Jr., M.D., San Bernardino County (Calif.) Medical Johnson, Kenneth C., McKay-Dee Hospital Center, letters and state- 391 465 Kennedy, L. M., D.D.S., American Dental Association, letter. Kopp, Č. Gary, Community Hospital in Nelson County (N. Dak.), letter LaCombe, James L., New Mexico Hospital Association, letter... Lancaster (Calif.) Community Hospital, J. A. Hagen, letter___ Langston, Phillip W., Hardin County (Tenn.) General Hospital, letter and Laredo (Tex.) Mercy Hospital, Sister Mary Maurelia Petrus, mailgram.. Leake County (Miss.) Memorial Hospital, Joe Cooper, statement... Lemburg, Dorothy, Mason (Tex.) Memorial Hospital, Inc., letter for- Lockhart, Candy, R.N., Texas Nurses Association, District No. 9, state- Logan, Arch H., Jr., M.D., Washington State Medical Association, letter.. Loudon County (Tenn.) Memorial Hospital, Samuel A. Harrison, M.D., Loughery, R. M., Washington (D.C.) Hospital Center, statement_.. Ludwig, Patric E., Michigan Hospital Association, statement.. Luebs, Harold W., Pittsburgh (Pa.) Children's Hospital, letter forwarded by Congressman William S. Moorhead.. Magee-Womens Hospital, Henry J. Smith, letter forwarded by Congress- Maine Hospital Association, Fletcher H. Bingham, letter.... Martin, William R., Estaugh Corp., statement_ Maryland, University of, Hospital, Shirley L., Milke, letter. Marylander, Stuart J., Southern California Hospital Council, statement.. Mason (Tex.) Memorial Hospital, Inc., Alex H. Grosse, Wayne Hofmann, LeRoy Stengel, and Dorothy Lemburg, letter forwarded by Congressman McKay-Dee Hospital Center, Kenneth C. Johnson, letters and statement. McNamara, Sister Anne L., St. Anthony Hospital, letter to Hon. Michael McTague, Wayne R., American Fork (Utah) Hospital, letter_- Mercy Hospital, Cedar Rapids, Iowa, Sister Mary Lawrence Hallagan, Mercy Hospital (Williston, N. Dak.), Irvin "Mike" Krause, letter 444 Michigan Hospital Association, Patric E. Ludwig, statement.. Milke, Shirley L., University of Maryland Hospital, letter.. Montefiore Hospital Association of Western Pennsylvania, Milton Porter and Irwin Goldberg, mailgram forwarded by Congressman William S. Moore, Hon. W. Henson, a Representative in Congress from the State 311 Naples (Fla.) Community Hospital, Laurence J. Hoffman and Warren E. 411 National Association of Blue Shield Plans, statement. National Health Law Program, Patricia A. Butler, letter with enclosure. National Senior Citizens Law Center, Sally Hart Wilson, statement.- Nebraska Hospital Association, Ronald L. Jensen, letter and statement.. Neely, James R., Pennsylvania Hospital Association, statement --- 454 205 378 New York Hospital Association, George B. Allen, letter and statement--439, 441 Nichols, T. K., M.D., Ellington Memorial Clinic, letter.. Northampton-Accomack Memorial Hospital, Nassawadox, Va., R. A. Cramer, letter to the Commissioner of Social Security forwarded by Congressman Thomas N. Downing- - - North Dakota University Medical Center Rehabilitation Hospital, Kenneth W. Aitchison, letter forwarded by Senator Quentin N. Burdick Ogren, Stuart D., Virginia Hospital Association, letter forwarded by Congressman Thomas N. Downing- Oregon, State of, Gov. Robert W. Straub, correspondence with Thomas J. 458 312 Pembina County (N. Dak.) Memorial Hospital, Ruth Hollis, R.N., letter 449 Petrus, Sister Mary Maurelia, Laredo (Tex.) Mercy Hospital, mailgram.. Pittsburgh (Pa.) Children's Hospital, Harold W. Luebs, letter forwarded Porter, Milton, Montefiore Hospital Association of Western Pennsylvania, mailgram forwarded by Congressman William S. Moorhead__. Presbyterian University Hospital, Edward H. Noroian, mailgram for- Redlands (Calif.) Community Hospital, George A. DeLange, letter--. Richardton (N. Dak.) Community Hospital, Sister Helen, letter forwarded 445 Roberts, Lynn N., St. Luke's Hospital, letter forwarded by Senator 444 Ryba, Gary M., Griggs County (N. Dak.) Hospital and Nursing Home, 448 St. Alexius Hospital, Sister M. Joanne, letter forwarded by Senator 447 St. Aloisius Hospital, Leo Geiger, letter with enclosure forwarded by 449 St. Anthony Hospital, Sister Anne L. McNamara, letter to Hon. Michael G. 314 St. David's Community Hospital, Joseph M. Guinn, letter forwarded by 216 St. Gerard's Community Hospital, Gene Hoefs, letter forwarded by 452 St. John's Hospital, Robert Wolter, letter forwarded by Senator Quentin 445 St. Joseph's Hospital, Sister Anita, letter forwarded by Senator Quentin N. 446 Seton Medical Center, Sister Damian, letter forwarded by Congressman 211 Smith, Henry J., Magec-Womens Hospital, letter forwarded by Congress- 458 Smith, Leslie A., New Hampshire Hospital Association, statement for- 205 Southern Baptist Hospital, Edward H. Clarkson, letter forwarded by Congresswoman Lindy (Mrs. Hale) Boggs - Southern California Hospital Council, Stuart J. Marylander, statement.. Southern California Orthopedic Surgical/Medical Group, Inc., Sonny P. Stanley (N. Dak.) Community Hospital, Charles Kramer, letter forwarded 451 Stengel, LeRoy, Mason (Tex.) Memorial Hospital, Inc., letter forwarded 314 Straub, Gov. Robert W., State of Oregon, correspondence with Thomas J. 312 Stringfield, C. David, Baptist Hospital, Nashville, Tenn., letter.. 330 448 Thompson, William M., M.D., American Medicorp, Inc., Medical Advisory 322 Towers, John L., San Antonio Community Hospital, letter. 464 Towner County (N. Dak.) Memorial Hospital, Sister M. Arnoldine, letter 449 Tresnowski, Bernard R., Blue Cross Association, statement.. 333 Ulrich, Rev. Larry K., Church of the Brethren General Board, statement__ 363 403 Utah State Hospital Association, John R. Walker, letter forwarded by 308 Utah Valley Hospital, Grant C. Burgon, letter forwarded by Congressman 309 Vierra, Richard, G. N. Wilcox Memorial Hospital & Health Clinic, letter... Walker, Joel H., Central Vermont Hospital, letter. - Walker, John R., Utah State Hospital Association, letter forwarded by 497 498 445 Washington (D.C.) Hospital Center, R. M. Loughery, statement.. Washington State Hospital Commission, Ludwig Lobe, letter forwarded Washington State Medical Association, Arch H. Logan, Jr., M.D., letter Welborn Baptist Hospital, Donald I. Gent, letter.... Wentworth Douglas Hospital, Richard E. Clark, letter forwarded by 325 206 Wightman, D. D., Dakota Hospital, letter forwarded by Senator Quentin 451 Wilcox, G. N., Memorial Hospital & Health Clinic, Richard Vierra, letter.... Wilson, Allen, Lindsay (Calif.) District Hospital, letter... Wilson, Sally Hart, National Senior Citizens Law Center, statement.. Wisconsin Hospital Association, Warren R. Von Ehren, letter.. Wolter, Robert, St. John's Hospital, letter forwarded by Senator Quentin Woodcock, L. G., Hospital Council of Northern California, statement.. Yates, William L., South Carolina Hospital Association, statement... Youngstown Hospital Association, William B. Esson, letter forwarded by 445 SELECTED ISSUES IN MEDICARE PROGRAM POLICY THURSDAY, JUNE 12, 1975 U.S. HOUSE OF REPRESENTATIVES, SUBCOMMITTEE ON HEALTH, COMMITTEE ON WAYS AND MEANS, Washington, D.C. The subcommittee met at 10:40 a.m., pursuant to notice, in the committee hearing room, Longworth House Office Building, Hon. Dan Rostenkowski (chairman of the subcommittee) presiding. Mr. ROSTENKOWSKI. The Subcommittee on Health will come to order. I have prepared a statement underlying this hearing and I ask unanimous consent that that statement and the press release announcing this meeting be included in the record at this point. Without objection. [The documents follow:] OPENING REMARKS OF CHAIRMAN ROSTENKOWSKI, HEARINGS OF SUBCOMMITTEE ON HEALTH, ON MEDICARE REGULATIONS, JUNE 12, 1975 The purpose of today's oversight hearing is to receive testimony from representatives of the professional community and the Department of Health, Education, and Welfare on four recently promulgated regulations relating to the medicare program. Each of these four regulations-to impose new utilization review requirements, to terminate the inpatient routine nursing salary cost differential, to revise the limit on reasonable costs for inpatient routine services, and to tie recognition of reasonable charge increases to an economic index-has given rise to substantial controversy and widespread adverse criticism from hospital and medical associations. The significance of the issues raised by these regulations is such as to warrant careful appraisal by the Subcommittee of their policy and administrative implications in the light of congressional intent relative to the conduct of the medicare program. While much of the discussion has revolved around the objections raised by segments of the professional community--and these views and interests are certainly of major importance-the Subcommittee is very much concerned about the impact and consequences of these regulations for medicare beneficiaries. Central to any consideration of regulatory changes in the program must be an evaluation of the likely effects on the availability, quality and cost of services furnished to beneficiaries. The Subcommittee wants to be sure that the interest of the beneficiaries is not lost sight of and that the discussion remains firmly focused on their status and needs. Clearly the issues raised by these regulations have sweeping implications. The utilization review regulations would introduce substantial changes in the scope and conduct of hospital and physician review activities. The Department has indicated, in promulgating these requirements, that they are intended to bring about a single, uniform review system for both medicare and medicaid and to bring utilization review activities more closely into line with the PSRO program. It is also asserted that these requirements are consistent with and implement the provisions enacted in the 1972 Social Security Amendments. Hospital and medical spokesmen have argued, however, that the utilization review regulations not only exceed the authority granted to the Secretary to issue regulations but introduce requirements that many hospitals, particularly rural hospitals, will not be able to meet, with potentially dire consequences for those hospitals and medicare beneficiaries. (1) |