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This testimony was presented to the House Ways & Means Committee on May 7.
The committee was warned of the demise of hospitals if Medicare (HCFA) and Medicaid should fail:
"On average, America's hospitals and health systems receive roughly half of their revenues from government programs like Medicare and Medicaid. If that much revenue were to be suddenly cut off, hospitals could not survive, and patient care could be jeopardized. Hospitals would not be able to pay vendors. They would not be able to purchase food, supplies, laundry services, maintain medical equipment -- in short, they would not be able to do the job their communities expect of them. All this would occur even as hospitals and health systems faced the substantial costs of addressing their own Year 2000 system needs.
HCFA must make sure its contractors have taken steps to ensure that their performance will not be interrupted by Year 2000 problems caused by the millennium bug. HCFA should make readily available its work plan for bringing the contractors into compliance and aggressively monitor their efforts. Letting the providers know what changes may be required of them is also important. This would allow both providers and contractors to prepare simultaneously and ensure that their systems are compatible."
But what can Congress, or anyone, do about this? The computer systems that run Medicare are
noncompliant, and there is little hope that they can get compliant. (Actually, there is no legitimate hope, but I want to maintain a cheery attitude.)
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Statement of Jennifer Jackson General Counsel and Vice President, Clinical Services, Connecticut Hospital Association on behalf of the American Hospital Association
Testimony Before the Subcommittee on Oversight of the House Committee on Ways and Means
Hearing on the Year 2000 Computer Problem
May 7, 1998
Madam Chairwoman, I am Jennifer Jackson, General Counsel and Vice President, Clinical Services, at the Connecticut Hospital Association. I am here on behalf of the American Hospital Association (AHA), which represents nearly 5,000 hospitals, health systems, networks, and other providers of care. . . .
Hospitals and health systems face the same potential problems as most other institutions. Cellular phones, pagers, security systems, elevators -- all could be affected by Year 2000 problems. However, hospitals are special places that also rely daily upon unique medical devices and equipment. We are concerned about the potential impact of Year 2000 computer problems on patient safety -- and hospitals, health care providers and their associations cannot reduce, let alone eliminate, that risk by themselves. We need your help and cooperation, and that of the federal agencies that regulate the health care field: namely, the Food and Drug Administration (FDA) and the Health Care Financing Administration (HCFA).
In particular, we need the federal government to exercise its authority in this area -- now. We need the federal government to create an atmosphere in which everyone involved in the health care field will view the full and timely disclosure of Year 2000 computer problems not only as diligent and prudent behavior -- the right thing to do -- but also as mandatory conduct.
One of our primary concerns has to do with potentially non-compliant medical devices and equipment. Microchips (or microprocessors) that use date-sensitive logic are embedded in many medical devices, and we need to find out whether those devices will be affected by the date change to the Year 2000, and, if so, how we can fix them to avoid an interruption or other malfunction. The manufacturers of these devices are the best and, and in some cases, the only source of this information. Assuming that prudent medical device and equipment manufacturers are engaging in Year 2000 testing, we need to know what they are discovering, especially if they are uncovering problems. Here lies the heart of our concern.
While we as health care providers can ask manufacturers to disclose Year 2000 information to us, we cannot force them to do so. We do not have the legislative or regulatory authority to compel disclosure. We believe that is a job for Congress and the FDA. . . .
We are committed to ensuring that our members are aware of the dangers of the millennium bug. We can make sure they have the latest information on what their colleagues and other organizations are doing to address the problem. And we can help them learn about solutions that can help them. . . .
When it comes to medical devices, however, our efforts are not going to be sufficient to solve the problem, unless the manufacturers cooperate fully and quickly. While we anticipate that the number of devices that are affected may be limited, it is critical that accurate and thorough information be available from manufacturers. Health care providers must inventory their thousands of devices and pieces of equipment. But information about whether these devices are Year 2000-compliant -- that is, whether or not they will be affected by the date change -- must come from the manufacturers. The FDA has a key role to play in this area. . . .
We believe that current regulations allow the FDA to require manufacturers of medical devices to perform Year 2000 testing and report adverse results. We urge that FDA be given whatever resources or support it may need from Congress to exercise its enforcement authority in this area.
The Role of the Health Care Financing Administration
On average, America's hospitals and health systems receive roughly half of their revenues from government programs like Medicare and Medicaid. If that much revenue were to be suddenly cut off, hospitals could not survive, and patient care could be jeopardized. Hospitals would not be able to pay vendors. They would not be able to purchase food, supplies, laundry services, maintain medical equipment -- in short, they would not be able to do the job their communities expect of them. All this would occur even as hospitals and health systems faced the substantial costs of addressing their own Year 2000 system needs.
HCFA must make sure its contractors have taken steps to ensure that their performance will not be interrupted by Year 2000 problems caused by the millennium bug. HCFA should make readily available its work plan for bringing the contractors into compliance and aggressively monitor their efforts. Letting the providers know what changes may be required of them is also important. This would allow both providers and contractors to prepare simultaneously and ensure that their systems are compatible.
Even if all contractors express confidence that their payment mechanisms will not be affected by the millennium bug, the possibility remains that unforeseen problems could crop up. Therefore, HCFA should establish a contingency plan in case contractors' payment mechanisms somehow fail at the turn of the century. . . .
And let me add that Medicare is certainly not the only payer for hospital services. Similar payment delays could occur if private health insurers and, in the case of Medicaid, individual states, have not addressed their own Year 2000 problems. The federal government has the power to prevent this from happening, and we urge you to use that power.
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