Lawmakers blame HCFA for budget woes

Lawmakers blame HCFA for budget woes

While members of the committees with jurisdiction over Medicare continue to scramble to find additional funds to try to ameliorate some of the cuts made by the 1997 Balanced Budget Act, a group of House Republicans Thursday said most of the blame for providers' current woes goes to the Health Care Financing Administration.

"At every opportunity, HCFA has chosen to interpret the BBA in the most austere way," said Rep. Anne Northup, R-Ky.

Rep. Lindsey Graham, R-S.C., said HCFA is short changing providers intentionally. "They're creating a crisis on purpose," he said. Not only is HCFA "nickel and diming our doctors and hospitals and nursing homes," but it is reducing payments to private managed care plans participating in the Medicare+Choice program "to make sure it doesn't succeed," Graham charged.

HCFA officials have said repeatedly that, in most cases, their hands have been tied by the very specific legislative language of the 1997 law. Next week, Medicare officials are scheduled to sit down with members of the House Commerce Health and Environment Subcommittee to try to work out which of the current payment problems can be addressed administratively, and which need to be fixed through legislation, Health and Environment Subcommittee Chairman Michael Bilirakis, R-Fla., told CongressDaily Thursday. Bilirakis said he hopes to put legislation to address the payment problems on a fast track. "We can't go home until we get this done," he said.

In a related development, Senate Judiciary Chairman Orrin Hatch, R-Utah, today introduced legislation that would force Medicare to speed its process for approving new treatments. At a news conference, Hatch said Medicare beneficiaries have to wait months, and sometimes years, "for the most innovative treatments to be approved by Medicare."

Hatch said beneficiaries are not eligible under current Medicare reimbursement rules for new, less invasive treatments for prostate cancer. Hatch added that Medicare took four and a half years to approve the use of coronary stents. Hatch's bill, cosponsored by Senate Majority Whip Don Nickles, R-Okla.-and Rep. Jim Ramstad, R-Minn.,in the House-would shorten time frames for Medicare coding of approved treatments, require Medicare to update its payment system annually, allow the use of external medical data in approvals, and reform Medicare's criteria for eligible outpatient treatments. Physicians, medical device manufacturers, and drug manufacturers endorsed the plan.

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