1-17-02

The Advisory Committee is charged with addressing a broad range of regulatory issues (i.e., health delivery systems, research, operations, pharmaceutical/biologic/device development) that apply to a wide variety of stakeholders (e.g., providers, consumers, insurers, manufacturers). The Advisory Committee’s ultimate goal will be to identify and prioritize the barriers that get in the way of "doing the job" and delivering high quality and safe care, services, and products to patients and consumers. To ensure that high priority objectives are accomplished, the Advisory Committee will adhere to a set of rules for deciding which specific problems it can tackle and what kinds of solutions it can offer. Following is a proposed set of principles that will help the Advisory Committee focus its efforts.

1. Make every effort to develop recommendations about issues or problems that have the most significant and most direct effect on improving care and services to patients and consumers.
2. Concentrate efforts on existing programs or policies and focus on solutions for reducing impediments to realizing current goals.
3. Select issues for deliberation on which meaningful progress can be made during the year, but that may not be entirely resolved, in addition to identifying and "fixing" several concrete problems. The Committee will identify a mix of immediate fixes (what can be done now), short-term fixes (what can be done in 6 to 12 months), and long-term fixes (beyond one year). Staff will provide assistance to members regarding what can be done by Executive Order, regulatory modification, or legislative change. The Committee will consider recommendations from the legislative, and executive branches of government as well as other sources (e.g., recommendations from physicians, health plans and providers, beneficiary advocates and beneficiaries, academic experts and the public).
4. Consistent with the Committee’s mission, concentrate on and prioritize operational issues or problems that will have the greatest impact for the greatest number of stakeholders and program dollars, to the best of our ability. For example, the Secretary recently cited the Medicare Secondary Payer form as a source of burden for both beneficiaries and providers because of the frequency with which it is required to be completed. Recent steps to reduce this frequency will have an impact on many stakeholders.

5. Attempt to identify the intent of the law and develop recommendations that will maintain or improve on the way in which that intent is accomplished. Focusing on the intent of the law will help the Committee to recognize competing objectives and interests in the regulatory scheme and will help determine how those interests can be balanced. If the Committee believes that it cannot achieve an objective by modifying the regulatory process or the regulation itself, then statutory changes consistent with this objective may be recommended.

1. The Advisory Committee will focus on how policies are implemented and not on the underlying statutory policy that may be necessary.
2. The Advisory Committee will consider new ways of achieving a given policy goal, and not confine itself to tinkering around the edges of existing structures and processes.

6. Attempt to identify problems that are likely to occur on an ongoing basis. While the Advisory Committee will likely hear testimony on past transitional problems, it should focus on persistent problems.

7. Consider the budget implications to the program trust fund and/or to the discretionary funding necessary to operate the program, as part of any recommendation made.

The Advisory Committee will not… 

1. Assess the adequacy of payment levels or the fairness and accuracy of payment methodologies. Providers’ sense of burden may be closely related to their sense of being underpaid. However, this issue is beyond the Committee’s charge.
2. Engage in "what if" scenarios about program statistics (e.g., changes in Medicare fee-for-service, managed care enrollment, and provider participation rates).
3. Pursue new policy goals.
4. Prioritize or make recommendations on issues that are anecdotal or relevant only to specific special interests.