Health Industry Likes Idea of Congress, Medicare Cutting Red Tape

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By Mike Stankiewicz

The health-care industry is applauding signals of greater cooperation between Congress and the Medicare agency in tackling burdensome regulations.

“It can be very beneficial for an agency to have lawmakers engage with them,” Dan Mendelson, president of Avalere Health, a health-care consulting company in Washington, told Bloomberg BNA Oct. 12. “If Congress demands or asks the agency to do something, and they’re both in agreement, it can be very useful in speeding up the process, including for deregulation.”

Mendelson’s comments are in relation to a letter from the chairman of a key Senate committee that praised the Centers for Medicare & Medicaid Services for requesting feedback from patients and health-care providers on ways to increase quality of patient care while reducing regulatory burden, and asked for specific ways Congress can assist the agency. The Department of Health and Human Services, the parent agency of CMS, has authority over regulatory issues, while Congress can make statutory changes.“I am committed to helping you achieve these goals of maintaining flexibility and efficiency throughout the Medicare program,” Sen. Orrin Hatch (R-Utah) wrote Oct. 6 to CMS Administrator Seema Verma. “Realizing that CMS is likely to receive recommendations for actions that are beyond the agency’s statutory authority, I am especially interested in promising [request for information] recommendations that require Congressional action.” The agency’s request for feedback is part of a “request for information” contained in several recent Medicare payment proposals, Hatch noted.

Lindsay Bealor Greenleaf, director at ADVI, a reimbursement and policy consulting firm that advises clients in the pharmaceutical industry, said the letter is a sign of good things to come for the industry.

“It was very encouraging to see CMS request stakeholder feedback in its proposed rules on how to streamline reporting requirements and reduce regulatory burdens in general,” she told Bloomberg BNA Oct. 12. “Hatch’s subsequent letter to CMS asking for ideas on how Congress could help in this effort is a promising sign that this administration and Congress will follow through on their promises to reduce regulatory burdens for providers.”

Proceed with Caution

While industry sees promise, an advocacy group for Medicare patients urged caution in making program changes. David A. Lipschutz, senior policy attorney for the Center for Medicare Advocacy, warned Congress and the CMS to proceed with caution when it comes to deregulation.

“Look before you leap. Do not start trying to reduce regulations for the sake of reducing regulations, there can be unintended consequences,” he said. “There are some important consumer protections that providers might see as burdensome, like paperwork requirements and notices, but ensuring that consumers are adequately protected is of the utmost importance.”

Hatch, in his letter, emphasized that a “thorough review of regulations” in conjunction with health-care providers will properly identify requirements that are outdated, unneeded, or contrary to high-quality and efficient care.

Another congressional committee, House Ways and Means, has launched its own effort to cut Medicare red tape. During the summer, health-care groups such as the American Hospital Association responded favorably to the panel’s effort, calling for Congress to scale back regulations they say burden hospitals and providers. Examples of requested relief include making bundled payment demonstrations voluntary, revising penalties for hospitals that have to readmit patients, and fashioning coverage changes for telehealth services.

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To contact the editor responsible for this story: Brian Broderick at

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The letter is at

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