CIS/Index
Copyright © 1999, Congressional Information
Service, Inc.
99 CIS S 36148
TITLE:
Implementation and Impact of Changes Made to Medicare by the 1997 Balanced
Budget Act
CIS-NO: 99-S361-48
SOURCE: Committee on Finance.
Senate
DOC-TYPE: Hearing Retrieve
the full text of testimony
DOC-NO: S. Hrg. 106-190
DATE: Mar. 17, June 9, 10, 1999
LENGTH: v+395 p. il.
CONG-SESS: 106-1
ITEM-NO: 1038-A; 1038-B
SUDOC:
Y4.F49:S.HRG.106-190
CIS DOCUMENT ON DEMAND: 1-800-227-2477 (Full
Text Reproductions)
INCLUDED IN LEGISLATIVE HISTORY OF: P.L.
106-113
SUMMARY:
Hearings to examine Health
Care Financing Administration (HCFA) implementation of medicare cost control
provisions in the Balanced Budget Act (BBA) of 1997, and to review implications
of BBA medicare cost control provisions for hospitals, skilled nursing
facilities, and home health care agencies.
Also examines HCFA
implementation of the Medicare+Choice program, which allows medicare recipients
to participate in a variety of private managed health care plans.
Supplementary material (p. 119-395) includes witnesses' written statements
and written replies to Committee questions, correspondence, and submitted
statements.
CONTENT-NOTATION: Medicare payment policies
revision, implementation and impact review
DESCRIPTORS:
MEDICARE; GOVERNMENT SPENDING; MEDICAL ECONOMICS;
MEDICAL REGULATION; HOSPITALS AND NURSING HOMES; HOME HEALTH SERVICES; MANAGED
HEALTH CARE; GENERAL ACCOUNTING OFFICE; HEALTH CARE FINANCING ADMINISTRATION;
BALANCED BUDGET ACT
99-S361-48 TESTIMONY NO: 1 Mar.
17, 1999 p. 5-29, 135-142
WITNESSES (and witness notations):
MIN DEPARLE, NANCY-ANN (Administrator, HCFA)
STATEMENT AND DISCUSSION:
Review of HCFA progress in
implementing medicare reforms required by BBA; elaboration on HCFA medicare
reform implementation measures and related issues.
CONTENT
NOTATION:
Medicare payment policies revision,
implementation and impact review
99-S361-48 TESTIMONY
NO: 2 Mar. 17, 1999 p. 29-40, 181-201, 318-325
WITNESSES (and witness notations):
WILENSKY, GAIL R.
(Chair, Medicare Payment Advisory Commission (MedPAC))
SCANLON, WILLIAM J. (Director, Health Financing and Public
Health Issues, Health, Education, and Human Services Division, GAO)
STATEMENTS AND DISCUSSION:
Review of MedPAC
recommendations regarding medicare payment policy; findings of GAO study
assessing HCFA efforts to implement BBA medicare provisions, including
Medicare+Choice program implementation.
CONTENT NOTATION:
Medicare payment policies revision, implementation and
impact review
TESTIMONY DESCRIPTORS:
MEDICARE PAYMENT ADVISORY COMMISSION
99-S361-48 TESTIMONY NO: 3 June 9, 1999 p. 42-62,
142-148, 156-180, 202-209
WITNESSES (and witness notations):
HASH, MICHAEL M. (Deputy Administrator, HCFA)
LIEBERMAN, STEVEN M. (Executive Associate Director, CBO)
SCANLON, WILLIAM J. (Director, Health Financing and Public
Health Issues, Health, Education, and Human Services Division, GAO)
STATEMENTS AND DISCUSSION:
Review of HCFA progress in
implementing Medicare+Choice program; overview of CBO projections of enrollment
in Medicare+Choice plans over 10 year period, with role of lower costs and
improved benefits in influencing growth in plan enrollment; impact of
risk adjustment on Medicare+Choice program payment rates, with
recommendations.
Assessment of BBA medicare payment
reforms impact on Medicare+Choice program; issues related to HCFA
Medicare+Choice program implementation under BBA.
CONTENT
NOTATION:
Medicare payment policies revision,
implementation and impact review
TESTIMONY DESCRIPTORS:
CONGRESSIONAL BUDGET OFFICE; RISK ANALYSIS; PROJECTIONS
99-S361-48 TESTIMONY NO: 4 June 9,
1999 p. 63-73, 125-135, 239-278
WITNESSES (and witness
notations):
CUMMING, ROBERT B. (Principal, Milliman &
Robertson, Inc.; representing American Academy of Actuaries)
DEMONTMOLLIN, STEPHEN J. (Vice President and General
Counsel, AvMed Health Plan; representing American Association of Health Plans)
SMITH, PETER (CEO, Ralin Medical, Inc)
STATEMENTS AND DISCUSSION:
Concerns regarding
risk adjustment methodology proposed by HCFA to pay
Medicare+Choice health plans; adverse impact of HCFA proposed risk
adjustment methodology on Medicare+Choice health plans, with
recommendations (related charts, p. 246-266).
INSERTION:
-- Rich, Michael W. (et al.), "Multidisciplinary
Intervention To Prevent the Readmission of Elderly Patients with Congestive
Heart Failure" New England Journal of Medicine, Nov. 2, 1995 (p. 273-278).
CONTENT NOTATION:
Medicare payment policies
revision, implementation and impact review
TESTIMONY DESCRIPTORS:
AMERICAN ACADEMY OF ACTUARIES; RISK ANALYSIS;
CARDIOVASCULAR DISEASES; AGED AND AGING
99-S361-48
TESTIMONY NO: 5 June 10, 1999 p. 76-104, 210-222
WITNESSES (and witness notations):
BERENSON, ROBERT A.
(Dr.) (Director, Center for Health Plans and Providers, HCFA)
VAN DE WATER, PAUL N. (Assistant Director, Budget
Analysis, CBO)
WILENSKY, GAIL R. (Chair, Medicare Payment
Advisory Commission)
SCANLON, WILLIAM J. (Director, Health
Financing and Public Health Issues, Health, Education, and Human Services
Division, GAO)
STATEMENTS AND DISCUSSION:
Impact of BBA on medicare fee-for-service program, with
recommendations; analysis of BBA impact on medicare payment policies involving
skilled nursing facilities and home health agencies; issues related to HCFA
medicare fee-for-service program implementation under BBA.
CONTENT NOTATION:
Medicare payment policies revision,
implementation and impact review
TESTIMONY DESCRIPTORS:
CONGRESSIONAL BUDGET OFFICE; MEDICARE PAYMENT ADVISORY
COMMISSION
99-S361-48 TESTIMONY NO: 6
June 10, 1999 p. 104-121, 149-155, 223-238, 279-312, 347-380
WITNESSES (and witness notations):
SCULLY,
THOMAS A. (President and CEO, Federation of American Health Systems)
SMITH, CHARLES M. (Dr.) (President and CEO, Christiana
Care Corp.; representing American Hospital Association)
BAILIS, SUSAN S. (Co-Chairman and Co-CEO, Solomont Bailis
Ventures; representing American Health Care Association)
LEWERS, D. TED (Dr.) (Vice Chair, AMA)
SUTHER, MARY (Chairman and CEO, Visiting Nurse Association
of Texas; representing National Association for Home Care)
STATEMENTS AND DISCUSSION:
Adverse impact of BBA
medicare spending reduction provisions on hospitals and skilled nursing
facilities, with recommendations (related graphs, p. 231-235 passim);
recommendations to improve medicare sustainable growth rate payment system for
physicians' services.
Concerns regarding impact of
reductions in medicare home health benefit on home health agencies (related
articles, tables, p. 284-312).
INSERTION:
-- Ernst & Young LLP and HCIA, Inc., "Comprehensive
Review of Hospital Finances in the Aftermath of the Balanced Budget Act of 1997"
Mar. 1999, with tables and graphs (p. 347-380).
CONTENT NOTATION:
Medicare payment policies revision, implementation and
impact review
TESTIMONY DESCRIPTORS:
AMERICAN MEDICAL ASSOCIATION; PHYSICIANS; PROFESSIONALS'
FEES; STATISTICAL DATA: HEALTH AND VITAL STATISTICS