Mr. Steve White, Immediate Past President of the Association of Health Facility Survey Agencies agreed that the current system is unfair. He also explained that inconsistencies among HCFA regional offices charged with evaluating state agencies produce uneven assessments of the states. He pointed out other situations in which the regional offices' interpretation and implementation of HCFA policies and regulations result in significant injustice to facilities as well as to state agencies. Since termination is such a draconian measure, some regions have devised ways to get around it. He told of a regional office that asked a state to allow facilities to correct the problem on site to bring them back into compliance.
Some regions do require terminations.
The final witness, Mr. Michael Hash, Deputy Administrator, Health Care Financing Administration, U.S. Department of Health and Human Services, described actions being taken to address the problems elucidated by the GAO report and Mr. White's comments. The main point of disagreement centered on the use of comparative surveys. HCFA is evaluating whether to increase the number conducted. HCFA does plan to decrease the lag time between the state survey and the federal comparative survey. Mr. Hash also discussed the pressures on state agencies to meet all HCFA's requirements with available resources.