Year 2000 Computing Crisis

This testimony discusses the readiness of automated systems that support the nation's delivery of health benefits and services to function reliability without interruption through the turn of the century. This includes the ability of Medicare to provide accurate benefits and services to millions of Americans and the overall readiness of the health care sector, including such key elements as biomedical equipment used in health care. Successful Year 2000 conversion is critical to these efforts. GAO discusses the findings from a recent report (GAO/AIMD-98-284, Sept. 1998) and its suggestions for strengthening the Health Care Financing Administration's (HCFA) Year 2000 efforts, describes actions taken on those recommendations, and provides its perspective on where HCFA stands today. GAO also discusses the Year 2000 compliance of biomedical equipment, such as cardiac defibrillators and monitoring systems. (See GAO/AIMD-98-240, Sept. 1998.)

GAO noted that: (1) as the nation's largest health care insurer, Medicare expects to process over a billion claims and pay $288 billion in benefits annually by 2000; (2) the Health Care Financing Administration (HCFA) has been responsive to GAO recommendations, and its top management is actively engaged in its year 2000 program; (3) to more effectively identify and manage risks, HCFA is relying on multiple sources of information, including test reports, reports from its independent validation and verification (IV&V) contractors, and weekly status reports from its recently established contractor and oversight teams; (4) HCFA is also more effectively managing its electronic data exchanges and has more clearly defined its testing procedures; (5) HCFA has also demonstrated progress in developing business continuity and contingency plans to ensure that, no matter what, beneficiaries will receive care and providers will be paid; (6) according to the Department of Health and Human Services' year 2000 quarterly progress report, all 25 of HCFA's internal mission-critical systems were reported to be compliant, as were 54 of the 78 external systems; (7) HCFA's reported progress on its external mission-critical systems is considerably overstated; (8) all 54 external systems that were reported as compliant have important associated qualifications exceptions, some of them very significant; (9) the IV&V contractor acknowledges that Medicare claims processing systems have made progress toward year 2000 compliance over the past year, yet the various qualifications inevitably mean that some renovation and a significant amount of retesting still needs to be accomplished before these systems can be considered compliant; (10) the question of whether medical devices such as magnetic resonance imaging systems, x-ray machines, pacemakers, and cardiac monitoring equipments can be counted on to work reliably on and after January 1, 2000, is critical to the nation's health care; (11) the Food and Drug Administration, which provides information from biomedical equipment manufacturers to the public, had a disappointing response rate from biomedical equipment manufacturers to its request for compliance information; and (12) until this information is obtained and publicized, consumers will remain in doubt as to the year 2000 readiness of key health care components.