April 20, 2019

Businesspeople air bureaucracy woes > Medicare under fire at Maine meeting

AUGUSTA — A new federal ombudsman has collected more than 150 cases of burdensome bureaucratic rule-making that he has deemed legitimate for further investigation.

Peter Barca, a former U.S. congressman from Wisconsin, was in Maine on Monday convening a panel of politically connected businesspeople and other entrepreneurs to hear other potential cases. In what was the only hearing to be held this year in New England, the panel was met with a barrage of complaints from home health care providers and related businesses over changes in Medicare rules.

For Barca and the regulatory fairness board — which is part of the federal Small Business Administration — the hearings across the nation are open season on all federal agencies. The Internal Revenue Service, the Occupational Safety and Health Administration, the Environmental Protection Agency — all are subject to the skepticism and umbrage of indignant businesspeople.

To the extent that the agencies and not the businesspeople themselves are to blame for problems, Barca is supposed to advocate for better rule-making. If entrepreneurs such as Wayne Eldridge have their way, Barca will be asking the agency in charge of doling out Medicare dollars, the Health Care Financing Administration, to back off the small guy.

Eldridge runs a three-man shop in Bangor that travels about giving X-rays to immobile people. Most of his clients are in nursing homes and most of his company’s revenues come from Medicare. A 1997 federal law instructed the federal agency in charge of Medicare to squeeze savings out of the program.

“I understand that HCFA is about money and politics,” the Bangor businessman said to the six-person fairness panel. “What about patient care and patient caring? There isn’t any fat to be cut in my company.”

Squeezing savings out of Medicare has also meant greater scrutiny of nursing homes and home health care businesses. With explicit directions from Congress to root out Medicare fraud, HCFA has stepped up its audits, raising the ire of the audited, whose descriptions of heavy-handed, mean-spirited bureaucrats reminded many of the recent congressional hearings on abuses by the IRS.

“I truly feel that we have been probed and prodded,” said Linda Hotchkiss, the director of Rural District Visiting Nurses of Farmington, N.H. “We are not historically problematic. We are hard-working. We are not new or fly-by-night. I am proud of our organization but I am not proud of our government.”

HCFA was not at the University of Maine at Augusta to defend itself on Monday and Barca’s panel was still in the fact-finding phase so it was unclear what action would be taken. But what was clear was that, through the ombudsman and his volunteer regional panels, the federal government has attempted to follow through on the spirit of the 1996 Small Business Regulatory Enforcement and Fairness Act, which directed federal agencies to simplify their rules and compliance procedures.

Those within the new ombudsman’s office say that the hearings are not meant simply as a cathartic experience for wronged businesspeople. They say that they are expected to follow through on complaints.

“Our goal is to really try to change the culture of Washington,” Barca said. “Regulatory reform has been on the top of the agenda for business for years.”

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