Medicare-Medicaid Administrative and Reimbursement Reform Act

Medicare - Medicaid Administrative and Reimbursement Reform Act - Establishes a new method of reimbursement for routine operating costs for hospitals under the Medicare and Medicaid programs. Requires the establishment of a uniform accounting and cost allocation system for determining operating and capital costs of hospitals providing services. Requires the establishment of a system by which hospitals will be classified by such criteria as: (1) size; (2) type of hospitals (general, teaching, or specialized care); and (3) other criteria.

Stipulates that the term "routine operating costs" does not include: (1) capital costs; (2) direct personnel and supply costs of hospital education and training programs; (3) costs of interns, residents, and non- administrative physicians; (4) energy costs associated with heating and cooling the hospital plant; and (5) malpractice insurance expense; or (6) ancillary service costs.

Directs the Secretary of Health Education, and Welfare to determine annually for the hospitals classified in each category of the hospital classification system established by this Act, an average per diem routine operating cost amount for use in determining the reasonable cost of that portion of the hospital's costs which consist of routine operating costs. Provides for the periodic increase during the year of the routine operating cost as determined pursuant to this Act to reflect increases in the cost of services which are attributable to inflation.

Provides for the adjustment of the routine operating cost of a hospital to reflect higher costs to such hospital of a case mix which requires a greater intensity of care than that for other hospitals in the same classification.

Directs the Secretary to establish a five-member Hospital Transitional Allowance Board to act on the applications of hospitals for reimbursement of expenses incurred in the retirement or conversion of underutilized facilities. Requires that such conversion promote efficient and economical delivery of services covered by the Medicare and Medicaid programs.

Establishes a plan for the reimbursement of physicians under which participating doctors of medicine or osteopathy would accept the assignment of patients' claims for reimbursement under the Medicare program. Requires the Secretary to establish procedures for expediting the payment of such assigned claims to physicians. Promulgates an incentive payment to encourage physicians to participate in the program of assignment of claims.

Sets forth criteria for determining the reasonable charge which may be made for physicians' services, and medical services, supplies and equipment under the Medicare and Medicaid programs.

Sets forth the conditions under which anesthesiologist, pathologists, and radiologists may be paid under the Medicare and Medicaid programs for patient care services.

Authorizes payment, under the Supplementary Medical Insurance Benefits program of Medicare, for antigens prepared by an allergist for a particular patient.

Permits the Secretary to make agreements with the States under which the services of a State health agency will be utilized for the purpose of determining whether an institution in such State qualifies as a skilled nursing facility for purposes of the Medicaid program.

Combines Medicare, Medicaid, Office of Long Term Care, and Bureau of Quality Assurance agencies into a single Administration for Health Care financing headed by an Assistant Secretary.

Establishes specific performance criteria with respect to State administration of Medicaid. Terminates the Health Insurance Benefits Advisory Council.

Authorizes the Secretary to make grants to public or nonprofit private regional pediatric respiratory centers affiliated with institutions in the prevention, diagnosis, and treatment of respiratory diseases in children and young adults and in providing health care services to children and young adults suffering from such diseases. Authorizes the appropriation of such sums as may be necessary for the making of such grants for fiscal year 1978 and the succeeding four fiscal years.