From the congressional perspective, the past year has been dominated by implementing and monitoring previously enacted legislation and planning for future legislative action. The changes enacted as part of the Omnibus Budget Reconciliation Act of 1990 were negotiated to stand as the savings initiatives in Medicare and Medicaid for 3 years, thus removing these programs from the annual deficit reduction legislation.1 In the absence of budget-cutting legislation, congressional attention turned to monitoring the implementation of legislation on Medicare payment of physicians and hospital capital and regulating Medicaid provider taxes and donations.
Implementation of the regulations was not without controversy between the administration and the authorizing committees in Congress. Draft physician payment regulations in June sparked a major controversy over the levels of the conversion factors to be used in implementing the resource-based, relative value fee schedule for Medicare. Oversight hearings were held in the three committees of jurisdiction, resulting
Feder J, Rowland D. Government. JAMA. 1992;268(3):362-364. doi:10.1001/jama.1992.03490030074034