MEDICARE-MEDICAID ADMINISTRATIVE AND REIMBURSEMENT REFORM ACT HEARINGS BEFORE THE SUBCOMMITTEE ON HEALTH OF THE COMMITTEE ON FINANCE 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 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 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 MICHAEL STERN, Staff Director 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 CONTENTS ADMINISTRATION WITNESS 78 213 132 293 432 PUBLIC WITNESSES by Robert McGlotten, legislative department, and Richard Shoemaker, social security department--- 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 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, American Health Care Association, Bruce D. Thevenot, administrator, gov- American Hospital Association, John Alexander McMahon, president, ac- companied by Alan Manzano, vice president and Leo J. Gehrig, M.D., 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., American Psychiatric Association, Dave M. Davis, M.D., immediate past president, Georgia Psychiatric Association, director of psychiatric serv- 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- 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. 228 409 156 Pago 252 170 341 293 156 264 409 403 358 170 Blue Cross Association, Neil Hollander, vice president for health care serv ices Hospitals, accompanied by Robert J. Samsel, president--- chairman, Department of Clinical Pathology, University of Oregon Medi- Hospital leges, accompanied by David D. Thompson, M.D., director, New York Hos- 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 director, 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- Aetna on behalf of Hospital Financing Study Group---- ers Association and American Association of Retired Persons -Hansen, Jacqueline, board chairman, Health Systems Agency, Kansas City Equitable Life Assurance Society of the United States, accompanied by America man cal Association, accompanied by Edgar T. Beddingfield, Jr., M.D., chair man, council on legislation --- Association Legislatures companied by John Huff, counsel--- Webber, Jackson & Curtis.- and chairman, Department of Clinical Pathology, University of Oregon 398 132 289 432 132 280 132 228 252 115 186 289 341 Insurance Association of Connecticut, John H. Filer, chairman and chief executive officer, Aetna Life and Casualty, accompanied by Burton E. Page Burton, senior vice president, group division, Aetna-- 398 Kansas Hospital Association, A. B. Davis, Jr., executive vice president and chairman, board of directors, accompanied by Frank L. Gentry, executive director.- 264 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--- 307 McMahon, John Alexander, president, American Hospital Association, ac companied by Alan Manzano, vice president and Leo J. Gehrig, M.D., senior vice president--- 139 Miller, Morton D., vice chairman, Equitable Life Assurance Society of the United States, accompanied by William C. White, Jr., vice president, 280 Moran, M. Gail, staff director, Committee on Human Resources, National Governors' Conference 317 Mott, Anthony, executive director, Finger Lakes Health Systems Agency, and chairman, Legislative Committee, American Association for Comprehensive Health Planning-- 132 Murphy, Richard E., legislative director, Service Employees International Union, accompanied by Stanley Wisniewski, research director, Service 272 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----- 307 National Association of Private Psychiatric Hospitals, Dave M. Davis, M.D., immediate past president, Georgia Psychiatric Association, director of psychiatric services, Peachtree-Parkwood Mental Center and Hospitals, Atlanta, Ga--- 409 National Conference of State Legislatures, Hon. David Hollister- 115 National Council of Community Hospitals, John F. Horty, president, accompanied by John Huff, counsel -- 186 National Council of Health Care Services, Harry Asmus, president, accompanied by Jack MacDonald, executive vice president.- 205 National Governors Conference, M. Gail Moran, staff director, committee on human resources. 317 National Retired Teachers Association, James M. Hacking, assistant legislative counsel - 432 Phillips, Charles D., Ed.D., president, American Protestant Hospital Association 197 Reba, Richard C., M.D., president, American College of Nuclear Physi cians, accompanied by John Dring; and Kenneth L. Nicolas, executive staff 401 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 332 Seidman, Bert, director, Social Security Department, AFL-CIO, accom panied by Robert McGlotten, Legislative Department, and Richard Shoemaker, Social Security Department 213 Service Employees International Union, Richard E. Murphy, legislative director; accompanied by Stanley Wisniewski, research director. 272 Stewart, Donald H., M.D., American Association of Neurological Surgeons- 293 Thevenot, Bruce D., administrator, Government Services Division, American Health Care Association - 200 Whalen, Dr. Robert P., on behalf of the Association of State and Territorial Health Officials 126 COMMUNICATIONS vice president 452 463 465 |