October 26, 2001

MedPAC Discusses Medicare Regulatory Relief

The MedPAC Commissioners Oct. 19 jointly reviewed eight draft recommendations intended to reduce Medicare complexity and regulatory burden. As requested by Congress in the Balanced Budget Refinement Act of 1999 (BBRA), MedPAC's final recommendations are due by the end of 2001. According to a MedPAC analyst, the draft recommendations reflect three areas commonly noted during extensive interviews with CMS staff, Medicare providers, and beneficiaries: excessive layers of administration; regulation proliferation; and technology issues.

The draft recommendations include creating a standard, nationwide system of claims processing; "hold harmless" protections for providers that have erred because of inaccurate guidance; re-thinking the need/function of CMS' regional offices; and allowing CMS to test regulations before implementation. The draft also proposed better coordination of enforcement activities between HHS and the Department of Justice, eliminating regulations deemed obsolete because of program changes, and congressional support for certain new technologies at CMS. The draft also encouraged more up-front provider "vetting" as a way to reduce "back-end" enforcement efforts.

An advisor to the Commissioners pointed out that several congressional Medicare regulatory reform/relief bills (e.g., MERFA, MRCRA, RACER) also address many of these issues. Additionally, several Commissioners pointed out that some of the problems and complexities within the Medicare system are politically driven and, therefore, would be difficult to resolve.

Following their review of the draft recommendations, the Commissioners considered several options for reimbursing hospitals for blood-related costs. The Commissioners agreed to continue their reimbursement discussion and refine their draft recommendations at their next meeting.

Information: Chris Mitchell, AAMC Office of Governmental Relations, 202-828-0526.