SAM BROWNBACK, Kansas

PETE V. DOMENICI, New Mexico
THAD COCHRAN, Mississippi

DON NICKLES, Oklahoma

ARLEN SPECTER, Pennsylvania
BOB SMITH, New Hampshire
ROBERT F. BENNETT, Utah

JOHN GLENN, Ohio

CARL LEVIN, Michigan

JOSEPH I. LIEBERMAN, Connecticut

DANIEL K. AKAKA, Hawaii

RICHARD J. DURBIN, Illinois

ROBERT G. TORRICELLI, New Jersey
MAX CLELAND, Georgia

TIMOTHY J. SHEA, Chief Counsel and Staff Director
JEFRREY S. ROBBINS, Chief Counsel to the Minority
MARY D. ROBERTSON, Chief Clerk

Opening statements:

Senator Collins

Senator Glenn

Senator Durbin

CONTENTS

WITNESSES

THURSDAY, JUNE 26, 1997

Hon. Charles E. Grassley, a U.S. Senator from the State of Iowa, and Chair-
man, Senate Special Committee on Aging

Hon. Tom Harkin, a U.S. Senator from the State of Iowa, and Ranking
Minority Member, Subcommittee on Labor, Health and Human Services,
Education and Related Agencies, Senate Committee on Appropriations

Michael F. Mangano, Principal Deputy Inspector General, U.S. Department

of Health and Human Services

Charles L. Owens, Chief, Financial Crimes Section, Federal Bureau of Inves-

tigation

Leslie G. Aronovitz, Associate Director, Health Financing and Systems Issues,

Health, Education and Human Services Division, U.S. General Accounting

Office

Pamela H. Bucy, Bainbridge Professor of Law, University of Alabama Law

School

Bruce C. Vladeck, Administrator, Health Care Financing Administration, U.S.

Department of Health and Human Services

..........

EXHIBIT LIST

*May Be Found In The Files of the Subcommittee

1. Letter from William J. Scanlon, Director, Health Financing and Systems

Issues, General Accounting Office, dated June 17, 1997, to The Honorable

Charles E. Grassley, Chairman, Senate Special Committee on Aging,

regarding Medicare: Problems Affecting HCFA's Ability to Set Appropriate

Reimbursement Rates for Medicare Equipment and Supplies, GAO/

HEHS-97-157R

2. Chart, Foley Latex Catheters Billed Under Medicare HCPCS Code A4338,

submitted by Senator Charles E. Grassley

................

3. GAO Report prepared for Senator Tom Harkin, Ranking Minority Mem-

ber, Subcommittee on Labor, Health and Human Services, Education,

and Related Agencies, Senate Committee on Appropriations, Medicare:

Need to Hold Home Health Agencies More Accountable for Inappropriate

Billings, June 1997 GAO/HEHS-97-108

Page

169

179

a. Federal Bureau of Investigation: Designed Health Care Squads

b. Resource Utilization: Health Care Fraud

180

4. Chart, Home Health Agency Claims Procedures, submitted by Michael

F. Mangano, Principal Deputy inspector General, Department of Health

and Human Services

197

5. Charts submitted by Charles L. Owens, Chief, Financial Crimes Section,

Federal Bureau of Investigation:

206

c. Pending Caseload: Health Care Fraud

d. Convictions: Health Care Fraud

e. Health Care Expenditures for 1996 in the United States: $1 Trillion

6. Charts prepared by the Permanent Subcommittee on Investigations:

a. The Home Health Care Industry

b. Los Angeles Medicare HMOs' Annual Disenrollment Rates, 1995

c. Home Health: Rapid Growth of Medicare Expenditures

7. Memoranda_prepared by Ian Simmons, Counsel, and Don Mullinax, In-

vestigator, Permanent Subcommittee on Investigations, dated June 19,

1997, to Permanent Subcommittee on Investigations' Membership Liai-

sons

8. a. Statement of June Gibbs Brown, Inspector General, Department of

Health and Human Services, before the House Committee on Ways

and Means, Subcommittee on Health, regarding Report of Depart-

ment of Health and Human Services, Office of Inspector General,

Report on the Financial Statement Audit of the Health Care Financing

Administration for Fiscal Year 1996

b. Report of the Department of Health and Human Services, Office of

Inspector General, Report on the Financial Statement Audit of the

Health Care Financing Administration for Fiscal Year 1996, July 1997

(A-17-95-00096)

9. GAO High-Risk Series, Medicare, February 1997, GAO/HR-97-10
10. GAO Report, Medicare: Excessive Payments for Medical Supplies Continue
Despite Improvements, August 1995, GAO/HEHS-95-171

11. GAO Report, Fraud and Abuse: Providers Target Medicare Patients in
Nursing Facilities, January 1996, GAO/HEHS-96-18

12. GAO Report, Medicare: Home Health Utilization Expands While Program
Controls Deteriorate, March 1996, GAO/HEHS-96-16

13. GAO Report, Medicare: HCFA Should Release Data to Aid Consumers,
Prompt Better HMO Performance, October 1996, GAO/HEHS-97-23

.........

14. GAO Report, Medicaid Fraud and Abuse: Stronger Action Needed to
Remove Excluded Providers From Federal Health Programs, March 1997,
GAO/HEHS-97-63

207

208

242

255

*

*