HCFA ‘Hated’ By “Everyone in Health Care,” Rovner Says
"It seems just about everyone in health care hates HCFA," Julie Rovner writes in her CongressDaily/A.M. column. Care providers "find its bureaucracy impenetrable," state officials "chafe" at the way requests to operate Medicaid and CHIP programs are "frequently thwarted" and free market analysts believe HCFA "represents a centralized, government way of doing business," Rovner writes. But according to Rovner, "no one hates HCFA more than Congress itself," which has made "HCFA-bashing" one of its "favorite participatory sports." While HCFA-bashers generally are Republicans, "they are not exclusively so," Rovner writes, noting that Sens. Frank Murkowski (R-Alaska) and John Kerry (D-Mass.) have introduced the Medicare Education and Regulatory Fairness Act (S 452) that would give physicians new "due process" rights in dealing with HCFA. But the bashing at times is "contradictory," Rovner says. For example, while legislators criticize HCFA for "heavy-handed anti-fraud tactics," they say the agency's 8.6% error rate still is "too high," even though it has dropped by half over the last four years. The reason for the drop is the agency's anti-fraud tactics, Rovner says, noting that Congress "ordered" many of them in the first place. In fact, Congress is actually "directly responsible for much of what ails HCFA," Rovner states, dividing the "problems" into three categories:
- "Too much to do": Through the 1996 Health Insurance Portability and Accountability Act, HCFA must issue new regulations on billing and medical privacy, as well as strengthen anti-fraud and abuse efforts. In addition, the 1997 Balanced Budget Act "saddled the agency with more than 300 new responsibilities."
- "Not enough money to do it with": Four "leading" Democrats on the Energy and Commerce committees stated in a recent letter that HCFA's budget has "barely" kept pace with inflation over the last eight years.
- "Not enough authority": HCFA has "limited power" over the insurance companies the agency contracts with to process Medicare provider bills because of the way Medicare was designed.
