March 26, 2003

Chairman Tauzin, Mr. Bilirakis, and Mr. Brown, I would like to thank you for your hard work on the Medicare Regulatory and Contracting Reform Act. It is always a pleasure to work with my colleagues on a bipartisan bill that responds to the needs of our constituents.

Medicare is a successful and efficient insurance program. It has provided beneficiaries high quality care with minimum administrative costs for over 40 years. Seniors report far greater satisfaction with Medicare than adults of any other age group report with their private insurance plans.

Of course, there is always room for improvement. This bill addresses concerns beneficiaries and providers have brought to us about unnecessary administrative barriers and regulatory burdens in the Medicare program. The bill includes provisions to streamline regulations, set clearer guidelines for providers to follow, and improve the appeals process.

I would like to highlight two provisions in particular. One section of the bill directs the Secretary to develop a plan for transferring the administrative law judges (ALJs) who hear Medicare appeals from the Social Security Administration to the Department of Health and Human Services. This transfer would enable a group of ALJs to specialize in Medicare cases and make the appeals process more efficient. We want, however, to assure that these ALJs remain unbiased, independent, and capable of providing the fair hearing to which Medicare beneficiaries are entitled. Consequently, the bill includes language specifying that the ALJs cannot be controlled by the Centers for Medicare and Medicaid Services (CMS) and must be independent.

The second provision addresses a problem seniors and people with disabilities face when they are unsure about what Medicare covers. Currently, if a beneficiary is notified that Medicare may not cover a procedure, the beneficiary must agree to pay for it up front and then submit the bill to Medicare. In many cases, Medicare ends up paying for the procedure. But some seniors have to forgo the care altogether because they cannot afford to take that chance. This provision would allow beneficiaries and their doctors to find out in advance if Medicare will pay for a particular item or service. As a result, more seniors and people with disabilities will be able to get the care they need.

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