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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




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