February 25,2000

Roth Requests HCFA Documents


WASHINGTON -- Senate Finance Committee Chairman William V. Roth, Jr. (R-DE) today asked Health and Human Services Secretary Donna Shalala and Health and Human Services Inspector General June Gibbs Brown for reports and "materials relating to the management and functioning of the Health Care Financing Administration (HCFA)."

In letters to Secretary Shalala and Inspector General Brown, Chairman Roth requested the materials, as the Committee "will be conducting inquiries into the current operational capacity and effectiveness of the Health Care Financing Administration to make sure we have the soundest possible foundation for carrying out modernization of the [Medicare] program."

The Finance Committee is currently holding hearings on Medicare reform.

The letters to Secretary Shalala and Inspector General Brown are attached.


ATTACHMENTS 

February 24, 2000
The Honorable Donna Shalala
Secretary of Health and Human Services
200 Independence Avenue, S.W.
Washington, D.C. 20201

Dear Secretary Shalala:

As Chairman of the Senate Finance Committee, it is my intention to continue this session the work on Medicare reform initiated last year. You will recall that in your testimony before the Committee on the President's original reform plan you indicated that the Administration envisions significant new roles and responsibilities for the Health Care Financing Administration. These roles and functions were in the areas of modernizing the fee-for-service plan, implementing a competitive health plan bidding system, and administering a new and comprehensive prescription drug benefit through entirely new modes of contracting. In addition, several reform options put forward by Members of the Congress also would require not just major additional commitments of federal resources in Medicare administration, but would require significant redirection in policy thinking and in operational approaches.

I am personally strongly committed to modernizing the Medicare program and to ensuring that the nearly 40 million beneficiaries depending on the program receive the medical services they need, including assistance on prescription drug costs. We have a shared responsibility, however, to fully understand the demands program reforms might place on the Health Care Financing Administration. We must arrive at a realistic assessment of the Agency's policy and operational capacity to absorb these new demands and implement changes effectively.

As part of the Committee's work on reform this year, we will be conducting oversight inquiries into the current operational capacity and effectiveness of the Health Care Financing Administration to make sure we have the soundest possible foundation for carrying out modernization of the program. Therefore, I am writing to request materials relating to the management and functioning of the Health Care Financing Administration (HCFA). The Committee's review will include, but will not be limited to, its financial management and operations, its performance related to Medicare and Medicaid implementation and responsibilities, and HCFA's management of its personnel. The review will also examine proposals intended to reform the Agency's administration of programs.

In furtherance of this review, I am requesting materials which outline the 1997 reorganization of HCFA, and the resulting current hierarchy, functions, budgets and responsibilities of offices within the Agency. I would also like to receive a description of how service complaints under the Medicare program, from either beneficiaries or health care providers, are handled, including the complaint review and response process, educational efforts, information hotlines, and any counseling or assistance services offered. Additionally, I request an outline of current Medicare contractor management policy, including scope of work statements and performance standards used to evaluate such contractors. I also request information on the Agency's processes for taking corrective action against poor contractor performance and for terminating and replacing contractors without disrupting beneficiary and provider services. Further, I request information on contractor costs, and numbers of FTE's under contract by major function. Separately, I also request a general statistical profile of the current HCFA workforce (by age, gender, length of service, number of employees at each GS-level, and number of political and career appointees in the Senior Executive Service within the Agency).

Please have these materials delivered to me by the close of business, March 17, 2000. Should you have any questions relating to this request, please have a member of your staff contact Kathy Means, (202) 224-4515. I thank you in advance for your assistance with this request.

Sincerely,

William V. Roth, Jr.
Chairman

cc: Hon. Daniel Patrick Moynihan


February 24, 2000
Ms. June Gibbs Brown
Inspector General
Department of Health and Human Services
330 Independence Avenue, S.W.
Washington, DC 20201

Dear Ms. Brown:

I am writing to request audit and investigative reports from the Department of Health and Human Service's Office of Inspector General (HHS/OIG) related to the management and functioning of the Health Care Financing Administration (HCFA). Effective oversight of agencies by the Inspector General is critical to ensuring that they are well-managed and able to fulfill their statutory responsibilities. As you may know, I have been a staunch proponent of this important function throughout my career. I understand that HHS/OIG has devoted significant resources to investigating and monitoring the operation of the Medicare and Medicaid programs. These activities are fundamental to detecting waste, fraud and abuse, as well as ensuring that beneficiaries receive the appropriate services under these programs. Since HCFA bears responsibility for administering these critical programs, I am also concerned about HCFA's own internal management.

As Chairman of the Finance Committee, which exercises oversight responsibility for HCFA as well as the HHS/OIG, I am planning to conduct a review of HCFA's management. This review will include, but will not be limited to, its financial management and operations, its performance related to Medicare and Medicaid program implementation and responsibilities, and HCFA's management of its personnel. In furtherance of this review, I am requesting any and all reports the Office of the Inspector General has done regarding HCFA's management, from both an investigative and audit perspective, for the last three fiscal years. I would like copies of all pertinent OIG reports, including any investigative documents or investigative statistics, for this time period. These statistics should include any internal statistics on employee-related misconduct, such as allegations of corruption, harassment, or discrimination.

In addition to the above information, I would like to schedule a briefing with your staff, to include key personnel from your organization who conduct audits or investigations related to HCFA management. Please have a member of your staff contact Ms. Kathryn Quinn, Investigative Counsel, at (202) 224-4515, to make arrangements for the briefing and delivery of the requested information. I would like to receive the requested information by March 21, 2000. Should you have any further questions, please feel free to contact Mr. Frank Polk, Staff Director/Chief Counsel, at (202) 224-4515.

Sincerely,

William V. Roth, Jr.
Chairman

cc: Senator Daniel Patrick Moynihan