Lawmakers Introduce Medicare Bill to Ease Audit Process
Supported by a number of groups representing health care providers, Sens. John Kerry (D-Mass.) and Frank Murkowski (R-Alaska) yesterday introduced legislation -- the Medicare Education and Regulatory Fairness Act -- that would revamp Medicare audit procedures, CongressDaily/A.M. reports (Rovner, CongressDaily/A.M., 3/8). The bill would allow providers to "challenge" HCFA regulations and contest overpayment decisions without losing their right to appeal, prevent the agency from recovering "past overpayments by withholding future payments" and prohibit the government from prosecuting providers who "voluntarily disclose" overbilling errors and return the payments within one year. (Murkowski release, 3/7). In addition, the legislation would require HCFA to educate providers about proper billing procedures (Anderson, StatesNews Service/Worcester Telegram & Gazette, 3/8). The bill would also "limit" HCFA's use of "extrapolation," a process in which the agency assumes billing errors found on sample audits were made regularly and increases repayment amounts accordingly. Reps. Patrick Toomey (R-Pa.) and Shelley Berkley (D-Nev.) have proposed a similar measure in the House. "All of us here recognize the need to ferret out waste, fraud and abuse. But we also have an obligation to ferret out stupidity and abusiveness," Kerry said (Rovner, CongressDaily/A.M., 3/8). Saying HCFA is sometimes an "out-of-control bureaucracy," he added, "I think it has been excessive in the way it has squeezed some of our providers" (Powell, Boston Herald, 3/8).