Congressman Bill Thomas (R-CA), Chairman, Subcommittee on Health of the Committee on Ways and Means, today announced that the Subcommittee will hold a hearing on recommendations regarding medicare hospital and physician payment policies. The hearing will take place on Thursday, March 20, 1997, in the main Committee hearing room, 1100 Longworth House Office Building, beginning at 10:00 a.m.
In view of the limited time available to hear witnesses, oral testimony at this hearing will be from invited witnesses only. Witnesses will include Dr. Joseph Newhouse, Chairman of the Prospective Payment Assessment Commission (ProPAC), and Dr. Gail Wilensky, Chairman of the Physician Payment Review Commission (PPRC). However, any individual or organization not scheduled for an oral appearance may submit a written statement for consideration by the Committee and for inclusion in the printed record of the hearing.
BACKGROUND
Medicare hospital and physician payments dominate the fee-for-service portion of the Medicare program. The Congressional Budget Office estimates that hospital payments will total $483 billion between fiscal years 1998 and 2002 -- about 68 percent of Part A fee-for-service payments. Physician fee schedule payments will total $372 billion during this same period, or about 46 percent of Part B fee-for-service payments. The President's fiscal year 1998 budget includes several provisions relating to these areas. These proposals will be examined in light of the recommendations from ProPAC and PPRC.
Since 1984, Medicare has paid for inpatient hospital services using a prospective payment system (PPS). This system offers incentives for hospitals to provide care in an efficient manner. At the same time, the inpatient hospital PPS recognizes the higher costs incurred by some institutions. The President's fiscal year 1998 budget includes several provisions related to hospitals including reducing the inpatient operating and capital payment rate updates, reducing the amount of additional payments to teaching and disproportionate share hospitals, and reducing payments for outlier cases. In addition, the President proposes to establish a PPS for outpatient services. In its March Report to Congress, ProPAC made several recommendations regarding these and other hospital payment issues.
In 1992, Medicare began reimbursing physicians using a resource-based relative value scale (RBRVS) system. At the same time, Medicare began to set annual volume performance standards for the rates of increase in Medicare physician expenditures and began to limit the amount of copayments that non-participating physicians could charge beneficiaries. Under the RBRVS system, each physician procedure has a work, malpractice, and practice expense component. The Health Care Financing Administration will be issuing a notice of proposed rule making this Spring to change the method for reimbursing physicians for their practice expenses. The new system will result in substantial changes for some medical specialties. In addition, the President's fiscal year 1998 budget includes several provisions related to physician services including moving to a single-conversion factor and reducing payments to high-cost hospital-based medical staffs. The Subcommittee will examine these and other physician issues as they compare to PPRC's recommendations.
In announcing the hearing, Chairman Thomas stated: Both the Prospective Payment Assessment Commission and the Physician Payment Review Commission have made significant recommendations, which this Subcommittee should give careful consideration to as we examine the President's budget and develop policy for the future of fee-for-service Medicare."
FOCUS OF THE HEARING:
This hearing will focus on the provisions in the President's fiscal year 1998 budget proposal regarding Medicare payments for hospitals and physicians. These proposals will be addressed in light of the recommendations developed by the Congress, by ProPAC and PPRC, as well as the policies contained in the Medicare Preservation Act of 1995 and the Balanced Budget Act of 1995.
DETAILS FOR SUBMISSION OF WRITTEN COMMENTS:
Any person or organization wishing to submit a written statement for the printed record of the hearing should submit at least six (6) copies of their statement and a 3.5-inch diskette in WordPerfect or ASCII format, with their address and date of hearing noted, by the close of business, Thursday, April 3, 1997, to A.L. Singleton, Chief of Staff, Committee on Ways and Means, U.S. House of Representatives, 1102 Longworth House Office Building, Washington, D.C. 20515. If those filing written statements wish to have their statements distributed to the press and interested public at the hearing, they may deliver 200 additional copies for this purpose to the Subcommittee on Health office, room 1136 Longworth House Office Building, at least one hour before the hearing begins.
FORMATTING REQUIREMENTS:
Each statement presented for printing to the Committee by a witness, any written statement or exhibit submitted for the printed record or any written comments in response to a request for written comments must conform to the guidelines listed below. Any statement or exhibit not in compliance with these guidelines will not be printed, but will be maintained in the Committee files for review and use by the Committee.
1. All statements and any accompanying exhibits for printing must be typed in single space on legal-size paper and may not exceed a total of 10 pages including attachments. At the same time written statements are submitted to the Committee, witnesses are now requested to submit their statements on a 3.5-inch diskette in WordPerfect or ASCII format.
2. Copies of whole documents submitted as exhibit material will not be accepted for printing. Instead, exhibit material should be referenced and quoted or paraphrased. All exhibit material not meeting these specifications will be maintained in the Committee files for review and use by the Committee.
3. A witness appearing at a public hearing, or submitting a statement for the record of a public hearing, or submitting written comments in response to a published request for comments by the Committee, must include on his statement or submission a list of all clients, persons, or organizations on whose behalf the witness appears.
4. A supplemental sheet must accompany each statement listing the name, full address, a telephone number where the witness or the designated representative may be reached and a topical outline or summary of the comments and recommendations in the full statement. This supplemental sheet will not be included in the printed record.
The above restrictions and limitations apply only to material being submitted for printing. Statements and exhibits or supplementary material submitted solely for distribution to the Members, the press and the public during the course of a public hearing may be submitted in other forms.
The
Committee seeks to make its facilities accessible to persons with
disabilities. If you are in need of special accommodations, please
call 202-225-1721 or 202-225-1904 TTD/TTY in advance of the event
(four business days notice is requested). Questions with regard to
special accommodation needs in general (including availability of
Committee materials in alternative formats) may be directed to the
Committee as noted above.