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B-164031(4) 1 (1971-03-24)

handle is hein.gao/gaobaaflh0001 and id is 1 raw text is: COMPTROLLER GENERAL OF THE UNITED STATES WASHINGTON, D.C. 20548 LM095686 MAR 4 rern r, Ali/r'i/t4 Z B-164031(4) Dear Mr. Burke: 411 This is in response to your letter of January 15, 1971, enclosing a copy of a letter to you from Mr. Charles J. Kelley, president of Massachusetts Council of Health Care Facilities, and _requestin our comments on his statements. Attached to Mr. Kelley's letter were copies of (1) a questionnaire which our Boston Regional Office recently sent to selected Medicare providers (hospitals and extended-care facil- ities) that had vouln ari y terminated their participation in the Medicare program and (2) Mr. Kelley's letter in response to that questionnaire. Because we were concerned about the large number of providers which had terminated participation in the program--Social Security Administration statistics showed that, as of June 30, 1969, about 1,000 extended-care facilities and 500 hospitals had terminated their participation from inception of the Medicare program in fiscal year 1967--we furnished these questionnaires to former providers. The pur- pose of the questionnaires was to obtain their views and comments on the reasons for terminating their participation in the program and on the effects that their terminations had on the availability of serv- ices to Medicare beneficiaries in their locality. We are pleased that Mr. Kelley reacted favorably to our approach of directly querying providers as to the reasons for their terminations from the program and that he provided us with meaningful comments. In his letter to you, Mr. Kelley stated that Medicare payments for services rendered to patients in extended-care facilities had decreased by 75 percent, whereas payments to hospitals had continued to increase at a rapid rate. He suggested that, in view of these statistics, it appeared that Medicare beneficiaries were receiving care in hospitals when they could be cared for in less expensive extended-care facilities. Under the Hospital Insurance Benefits for the Aged portion of the Medicare program, an eligible person aged 65 or over is provided with basic protection against the costs of care provided by (1) a hospital during the acute stage of his condition and (2) an extended-care facil- ity when he receives skilled nursing care on a continuous basis for a 50TH ANNIVERSARY 1921-1971

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