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 consumer protections and quality standards for Medicare beneficiaries. The hearing will take place on Thursday, March 6, 1997, in 1310 Longworth House Office Building, beginning at 1:00 p.m.
In view of the limited time available to hear witnesses, oral testimony will be heard from invited witnesses only. 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
The percentage of Medicare beneficiaries choosing to enroll in Medicare risk HMOs has nearly tripled since 1991, and the Congressional Budget Office predicts that more than one third of beneficiaries will be enrolled in HMOs by the year 2007. As this trend continues, there has been an increasing focus on quality and consumer protections in the Medicare risk contracting program.
The Medicare program currently has significant safeguards in place to ensure that beneficiaries enrolled in risk plans receive quality health care. For example, Medicare managed care plan enrollees have the right to appeal any benefit decision by a provider or a plan, including the length of time authorized for a hospital stay. In addition, beneficiaries have the right to an expedited review by a Peer Review Organization if they feel they may be discharged prematurely from a hospital.
The Health Care Financing Administration (HCFA) has undertaken a number of recent actions intended to provide Medicare managed care enrollees with additional protections and with information about health plan quality so that beneficiaries can make more informed choices about the risk plans available to them.
President Clinton's fiscal year 1998 budget proposal includes a number of provisions granting the Administrator of HCFA greater authority over Medicare managed care and Medigap plans. These proposals would allow HCFA to establish an annual coordinated open enrollment period for Medicare managed care and Medigap plans, provide beneficiaries with comparative information on plan options, repeal the outdated 50/50 rule, and restrict the additional benefits that may be offered by Medicare managed care plans to standardized packages prescribed by HCFA.
In addition, many States recently have adopted managed care consumer protection laws and the largest association representing the managed care industry has announced a series of voluntary initiatives aimed at ensuring that consumer protections are in place in the private market.
In announcing the hearing, Chairman Thomas stated: "In response to public concerns about managed care, HCFA has taken the initiative in its oversight of private Medicare plans. These initiatives have been well-reasoned, and I look forward to learning more about the Administration's response to some of the warning signs that have been raised about managed care."
FOCUS OF THE HEARING
The hearing will focus on HCFA's recent actions to improve consumer protections and quality assessment in the Medicare risk program. It also will focus on provisions in President Clinton's fiscal year 1998 budget proposal relating to quality and consumer protection in the Medicare program. The Administration's efforts will be assessed in light of State and private sector efforts to improve quality in managed care plans.
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, March 20, 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.