College of American Pathologists
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Reinventing HCFA

March 2001
Mary Jane Gore

In a CAP TODAY interview, Rep. James Greenwood (R-Pa.), the new chairman of the House Energy and Commerce Committee’s subcommittee on oversight and investigations, said he is developing plans to reinvent the Health Care Financing Administration.

Greenwood and seven colleagues last month toured HCFA headquarters near Baltimore and met with agency leaders. "We think right now that the focus will not be narrowly on waste and abuse, but on creating a new vision for how HCFA should be organized to provide the best service to beneficiaries as well as taxpayers and health care providers," he says.

"We will look at the agency’s entire architecture," he adds. "I think the thing to do is to wipe the slate clean. It is an intellectual exercise: If you want to provide health care to 70 million Medicare beneficiaries and millions of Medicaid beneficiaries, disabled people, and children without insurance, how would you design this program? That’s an open question in my mind. We are going to speak to a lot of smart people, including the leaders of HCFA."

Greenwood says he needs answers about how to provide the best care while ensuring beneficiaries and taxpayers don’t pay more than necessary.

Referring to the recent IOM report on the Medicare laboratory fee schedule, which suggests reducing the number of carriers, Greenwood says: "The system has been in place since 1967, and HFCA does not have legislative or statutory authority to change the current system. There is a question in my mind about how competitive the system is and how much quality you get when HCFA cannot change those carriers and you don’t have competition."