Opening Statement of the Hon. Nancy L. Johnson, a Representative in Congress from the State of Connecticut,
and Chairwoman, Subcommittee on Health

Hearing on Medicare Reform: Bringing Regulatory Relief to Beneficiaries and Providers

March 15, 2001

Today, there are more than 130,000 pages of Medicare regulations. That's four times the number of IRS! This regulatory burden is a consequence of Medicare's administered pricing system, which requires government micro-management of health care. Certainly, this is not all the fault of the Health Care Financing Administration (HCFA). Indeed, Congress has enacted significant Medicare legislation in three of the last four years.

The purpose of this hearing is to examine the impact of the regulatory burden on beneficiaries and the providers that serve them, and to examine specific proposals to provide regulatory relief. Our intent is to distinguish between unnecessary regulations and those that are critical to program integrity and effectively deter fraud and abuse.

Our witnesses will provide us with specific examples of burdensome regulations - and specific suggestions for regulatory changes that can be made to promote efforts to improve the Medicare program. The Subcommittee will be presented with testimony on how the government can do its job better, to ensure that beneficiaries are protected and that taxpayer dollars are used wisely and responsibly without placing undue burdens on providers.

I thought it was important to begin with this topic because, like many of my colleagues, I hear nearly every day from doctors and home health agencies, from nursing home administrators and durable medical equipment providers, that the status quo is unacceptable. Too many health care providers are spending too much time struggling with paperwork rather than treating patients. It is time to introduce a little commonsense into the HCFA bureaucracy.

As this Committee continues to prepare, through our hearings and bipartisan seminars, for the development of Medicare improvement legislation, we need to keep what we will hear from our witnesses today in the forefront of our minds. We must not simply feed the regulatory monster - we must instead make it a priority to improve administrative responsiveness to beneficiaries and providers. We will work closely with Secretary Thompson, who we heard from yesterday, to explore how HCFA can be restructured as we work to modernize Medicare.

As we think about regulatory relief, however, it is vitally important that we not allow ourselves to believe that all regulation is inappropriate - in fact, patient protections, financial accountability standards, and operational guidance are a vital part of the Medicare program. Just last week, the Office of Inspector General reported that inappropriate Medicare claims had fallen to 6.8% from 14% in 1996. That's good news for taxpayers and beneficiaries who are paying the bills. However, some of HCFA's 130,000 pages of regulations clearly cross a line and place an unnecessary burden on providers - a burden that can negatively affect the beneficiaries who rely on them for needed services.

We will have to be sensitive to this balance between accountability and relief as we hear from our witnesses today and as we move forward in developing legislation. But, I am confident that as we work together we will get it right. No matter what shape a modernized Medicare program ultimately takes, we all know that one of the most important measures of its success will be whether we can protect program integrity while ensuring that health care providers can focus on patients rather than paper.