HFCA Faces Investigation from Congressional Panels
Two House Energy and Commerce subcommittees Thursday jointly held the first in a series of hearings on the operations of HCFA -- the "oft-maligned" agency that runs Medicare, Medicaid and CHIP -- but some key Democrats have "already complain[ed]" that the bipartisan effort to improve program operations may "turn into something very different," CongressDaily/AM reports. House Energy and Commerce health subcommittee ranking member Sherrod Brown (D-Ohio) said he "feared" the "intent of the subcommittee is to accelerate the privatization of Medicare" and put HCFA "out of business." In addition, while Brown conceded that HCFA has not always "worked as well as it should," he pointed out that during the past several years, Congress has burdened the agency with more responsibilities but provided "few" additional resources, leaving HCFA "chronically overburdened and underfunded." Meanwhile, Rep. Peter Deutsch (D-Fla.), ranking member of the Energy and Commerce oversight and investigations subcommittee, called the hearings "premature." He said, "We generally do our investigation first, then hold a hearing to report what we have found. What is somewhat frustrating about today's meeting is that we have not yet completed -- or even really begun -- a cursory investigation into this matter."
However, Republicans said they have no agenda "other than to help patients." Oversight and investigations subcommittee Chair James Greenwood (R-Pa.) said, "I would hope none of us demonize HCFA. What we're about here is trying to figure out ... whether there's a better way to structure [HCFA] to serve the seniors and the kids and other people." Still, Republicans criticized the agency, CongressDaily/A.M. reports. "This agency has a very real -- and sometimes negative -- impact on the quality of care delivered to patients through federal health programs," health subcommittee Chair Michael Bilirakis (R-Fla.) said, adding, "Too often, HCFA is inflexible and unresponsive to patient needs."
During the hearing, doctors and patients said HCFA fails to swiftly approve and cover under Medicare new technologies and services, such as PET scans and new treatments for coronary artery disease (Rovner/Fulton, CongressDaily/A.M., 3/2). According to Clifford Goodman, senior scientist at the Lewin Group, HCFA's decisions about coverage and reimbursement remain "largely uncoordinated." He said, "As a result, it can take 15 months to five years, and in some cases longer, to add new technologies to Medicare" (MacDonald, Hartford Courant, 3/2). Jeff Kang, head of HCFA's Office of Clinical Standards and Quality, conceded that the agency has "not been as efficient as it could have been," but added that "recent improvements" should "smooth" operations (CongressDaily/A.M., 3/2). "We recognize that our process is not perfect and in the past we have, at times, been slower than necessary to incorporate new technology into the Medicare program," he said, but added, "We must act as a prudent purchaser on behalf of our beneficiaries and hundreds of millions of taxpayers. We must also consider and incorporate the views and interests of many stakeholders, including beneficiaries, providers, manufacturers, private health plans, taxpayers, Congress and others" (Hartford Courant, 3/2).