Gail Wilensky, administrator of the Medicaid and Medicare programs, wants to chop a month and a half from the average time it takes to develop a regulation to carry out program laws.

Wilensky said it takes an average of 130 days to clear a regulation through her agency, the Health Care Financing Administration of the Department of Health and Human Services. She wants to cut that to 88 days.

The agency could save time, she said, by setting an annual agenda and designating the most important regulations for priority action. Another step would be to bring the administrator and her deputy into the discussions of a proposed regulation early to give lower-level officials policy guidance and avoid protracted conflict over issues that could be settled early. Still another step would be to consult with outside groups early in the regulation-drafting process.

If her plan works, she said, it would make for better rule-making. "Not miraculously better, but better."

Wilensky also said the department has determined that HHS Secretary Louis W. Sullivan has the legal power to grant waivers from normal Medicaid rules to the state of Oregon so it can carry out its proposed "rationing" plan for Medicaid benefits.

She said she is sympathetic to giving a state flexibility to provide Medicaid assistance for its poorest residents in the way it thinks best. But she said that under the law Oregon must meet various requirements to get a waiver, and until more information is available on the details of the state's proposals, she does not know whether she would recommend to Sullivan that the Oregon waiver be granted.