Dear Administrator McClellan:
As Chairman and Ranking Member of the United States Committee on Finance
(Committee), which has jurisdiction over, among other things, the Medicare and Medicaid programs, we have a responsibility to protect these programs, their funding, and the more than 80 million beneficiaries who receive healthcare through them. In carrying out our responsibility, we have engaged your office and other stakeholders over the past several months regarding the Quality Improvement Organizations (QIO).
In correspondence dated April 27, 2006, the American Health Quality Association
(AHQA), which represents the interests of most QIOs, submitted recommendations to your office designed to “ensure accountability of the QIO program." AHQA’s proposal included an increase in funding and a lengthening of the QIO contract cycle. We support increased accountability;
however, our Committee’s inquiry thus far indicates that the QIO program may require greater reform.
We believe it is premature to provide the QIOs with additional funds and lengthened contract cycles until the numerous ongoing inquiries into the QIOs’ operations are complete.
Our Committee continues its inquiry into allegations of, among other things, financial improprieties by the QIOs, including but not limited to, questionable travel and conference expenses, possible misuse of rental property, and loans executed to subsidiaries. The Government Accountability Office and the Office of Inspector General for the Department of Health and Human Services are also conducting reviews of the QIOs.
Furthermore, if the problems were confined to financial improprieties and conflicts of interest, increased oversight would suffice. However, in addition to these potentially serious problems, there is still a need for more thorough evaluation of the QIOs’ effectiveness in improving the quality of healthcare, as confirmed by the recent Institute of Medicine report.
We would like our staffs to discuss legislative and administrative changes necessary to ensure that QIOs improve the quality of healthcare for Medicare beneficiaries, use resources judiciously, and adhere to ethical business practices. We look forward to hearing from you and working together on this issue.
Sincerely,
Charles E. Grassley Chairman
Max Baucus Ranking Member
Source: Ranking Member’s News
