Bush administration to push Medicare competition
Cut proposed in number of contractors
Thomas Scully, new head of the recently renamed Centers for Medicare & Medicaid Services (formerly the Health Care Financing Administration), says one of his top policy priorities will be to inject more competition into the Medicare contractor bidding process. Scully plans to accomplish this by cutting the number of Medicare fiscal intermediaries and making the bidding process more competitive — moves that are likely to be opposed by those intermediaries.
Testifying recently before the Senate, Scully said he feels the process for selecting unnecessarily limits the number of contractors that can bid. He said he and Health and Human Services Secretary Tommy Thompson want to see the law changed to allow prospective contractors to bid.
CMS also hopes reducing the number of Medicare contractors will eliminate some of the confusion currently caused by the disparity in reimbursement policies among different contractors across the country, as well as gaps in quality of service.
Other goals
Other changes the Bush administration plans to implement when it comes to Medicare payment practices include the following, according to CMS officials’ Senate testimony:
• move from paper transactions and communications to a paperless, automated system;
• eliminate regulatory red tape for providers, reduce unnecessary burdens, and establish key contacts for each state in CMS regional offices who will answer providers’ questions and address their concerns;
• update information technology with a common, departmentwide computer system and a single, up-to-date financial management system for CMS;
• ensure materials, including regulations, are written in "plain, understandable English" instead of the dry and confusing language of bureaucrats;
• expand provider and beneficiary education campaigns, making the toll-free information line for consumers operative 24 hours a day by October and posting more information on CMS on the agency’s Web site.
In a June 14 letter, Scully told Rep. Nancy L. Johnston (R-CT), House Ways and Means Subcommittee on Health chairwoman, and ranking minority member Fortney H. Stark (D-CA) that one of the managed care innovations he wants to implement is allowing beneficiaries to enroll on-line. "We are in the process of reviewing waiver requests, some of which include on-line enrollment," he said. "Once approved, we will monitor and consider new procedures for further pilot testing and/or national implementation of on-line enrollment."
Scully’s letter also mentioned the administration’s commitment to finding a way to accomplish more accurate risk-adjusted payments. "The improved approach will incorporate ambulatory diagnoses beyond those collected in an inpatient setting," he said. In addition to more accurate payments, the collection methods will be less burdensome to the industry.
Other steps the agency has already taken to reduce the review process for beneficiary documents include:
— establishing a 10-day review period for Medicare+Choice organizations that use model materials without modification that describe their 2002 benefits, including the Annual Notice of Change and the Summary of Benefits;
— allowing Medicare+Choice organizations to release their notices of change and summaries prior to approval of their adjusted community rate proposals, provided these materials include the disclaimer "pending federal approval"
— suspending the final verification requirement for notices of change and summaries. Rather than being required to send a copy to CMS for approval prior to printing and dissemination, the Medicare+Choice organization will only have to send a copy after the materials have been sent to beneficiaries.
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