S. 837, S. 1323, and H.R. 1868

GAO testified on its views on S. 837, S. 1323, and H.R. 1868, bills that would afford beneficiaries protection under Social Security Act health care programs from unfit health care practitioners. Each bill proposes consolidation of current legislative authorities and provides new authorities to the Department of Health and Human Services (HHS) to exclude unfit and unethical health care practitioners from participation in the act's health care programs. GAO stated that H.R. 1868 contains several additional provisions not found in S. 1323, which include: (1) authorizing HHS to exclude from Medicare and Medicaid health care providers who fail to provide medically necessary care required by law or contract; (2) requiring states to exclude organizations that are affiliated with individuals convicted of certain crimes or those excluded from social security health care programs; (3) exclusion-related provisions which apply to all social security health care programs, not just Medicare and Medicaid. GAO noted a provision contained in S. 1323, but not in H.R. 1868, to amend Medicare and Medicaid law to prohibit payment for services furnished under the direction of or on the prescription of an excluded physician. GAO supports the additional provisions and stated that it would support extending the payment prohibition provision to other types of practitioners who participate in the programs.