Health care providers complain about HCFA paperwork burdens

Health care providers last week told a House Ways and Means Health Subcommittee that they are overwhelmed by the paperwork and regulatory burdens placed on them by the Health Care Financing Administration.

But subcommittee Democrats reminded them that the burdens are comparable, if not lighter, than those placed on them by private insurers.

"I'm not suggesting we can't improve, but I don't think you're saying turn over our [Medicare payment and auditing process] to Aetna," said Health Subcommittee ranking member Fortney (Pete) Stark, D-Calif.

American Medical Association President-elect Richard Corlin, under questioning by Rep. Jim McCrery, R-La., said that claims processing was difficult "across the board" for Medicare and HMOs.

But Gary Mecklenburg, speaking on behalf of the American Hospital Association, said Medicare is worse. Others agreed.

"In the private sector, we definitely have our problems," said Susan Wilson, on behalf of the National Association for Home Care. "But we can seek resolution with them in terms of care.... This is not so with HCFA."

The hearing, the second in a series on Medicare reform, solicited suggestions from providers.

"We're not here to claim that changing the administrative burden is the whole problem," said Health Subcommittee Chairwoman Nancy Johnson, R-Conn.

Corlin urged members to support the recently introduced Medicare Education and Regulatory Fairness Act, which would give providers more recourse to battle with the agency.

"Passage of this legislation, independent of any HCFA reform efforts, would send a clear message to HCFA and its contractors that Congress wants them to focus on educating physicians and providers about how to bill correctly, rather than to conduct heavy-handed audits of already submitted claims," Corlin said.

But in an analysis Stark released Friday, he said Corlin's Medicare act would "provide unscrupulous providers a road map with clear directions about how to bill the program."

Separately, Johnson told health reporters Friday morning that addressing HCFA's regulatory problems is a key portion of her agenda for the subcommittee.

She told of one home health agency in her state that will soon stop serving beneficiaries who are "dually eligible" for Medicare and Medicaid because it cannot solve its regulatory hassle.

" 'If we don't comply, we're illegal with Medicare,' " she said the agency told her. " 'If we do, we're illegal with Medicaid.' You can't have a system that depends on your congresswoman intervening."

But Johnson said at least some of HCFA's problems are Congress' own doing, because lawmakers have passed too much complicated legislation.

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