Medicare chief apologizes for refusing to testify

Ending a month-long tug-of-war between the administration and a House Republican committee chairman, Centers for Medicare and Medicaid Services Administrator Thomas Scully appeared before the Small Business Committee Thursday and apologized for "the events of April 10" in which he defied a subpoena to appear before the panel.

"These events had the unfortunate effect of shifting the focus away from what you and I care about--small business providers," Scully told the committee. Scully had refused to appear on the same panel as small businesses who were to voice concerns with CMS regulations, paperwork burdens and physicians who stop treating Medicare patients. But today, sitting side-by-side with them, Scully pledged to continue efforts to make the agency more business-friendly.

House Small Business Chairman Donald Manzullo, R-Ill., who had earlier called for Scully's resignation, accepted his apology and said the agency "must demonstrate that it is responsive not just to the Ways and Means Committee or the Energy and Commerce Committee but to all the committees of Congress."

Scully listed several examples of how the agency is improving its relationship with small business. Scully said it has conducted numerous town hall meetings, is working closely with the Small Business Administration and has created policy forums to interact with beneficiaries, providers, suppliers, physicians and health plans. However, Scully reiterated the agency's position that it has no power to fix previous errors that led to cuts in physician reimbursement rates, despite what Congress says.

"We recognize that the size of the payment reductions this year may be difficult for some providers, but we do not have any administrative authority under the law to adjust payment levels for specific provider types or particular services," he said.

The issue has become a sticking point in the Medicare drug discussions. While a provision to clarify that CMS does have the authority may be included in the supplemental, House Energy and Commerce Chairman W.J. (Billy) Tauzin, R-La., will not likely include it in the bioterrorism bill.