ACP-ASIM Applauds House Efforts to Reduce Medicare Hassles
Wednesday, October 3, 2001
(Washington, DC): The members of the American College of Physicians - American Society of Internal Medicine (ACP-ASIM) are pleased that key health committees in the House of Representative are taking action to reduce unnecessary Medicare regulatory hassles and paperwork, announced ACP-ASIM President Bill Hall, MD, FACP, today.
"Time is the most valuable resource in diagnosing and caring for older adults, but it is in short supply due to unnecessary paperwork," said Dr. Hall. "Medicare patients suffer when physicians and their office staff are diverted from patient care activities to paperwork."
House Energy and Commerce Committee Chairman W. J. "Billy" Tauzin and ranking minority member John D. Dingell joined with Representatives Toomey, Berkley, Bilirakis, Brown, Norwood and Burr in announcing a legislative proposal today to help reduce Medicare regulatory hassles.
"Although we cannot endorse the Energy and Commerce Committee bill without a complete review of the actual legislative language, our initial reading of the summary suggests that the bill would begin to address some of the concerns that physicians have about the current Medicare program," said Dr. Hall.
Representative Nancy Johnson, chairwoman of the House Ways and Means Committee's Subcommittee on Health, and ranking minority member Pete Stark introduced another bill aimed at reducing Medicare hassles on August 2, 2001.
Dr. Hall suggested a number of provisions that should be included in a Medicare regulatory reform bill:
- Eliminate the extrapolation of alleged overpayment amounts to other non-audited claims the first time a physician or other health care provider is assessed an alleged overpayment, unless fraud is suspected. ACP-ASIM also recommends that carriers should conduct a documented education effort before a provider receives an overpayment demand letter.
- Physicians and other health care providers should be entitled to repayment plans if their overpayments would impact the financial well-being of their practice. Providers should have the option of a three-year payment plan or offset plan against future Medicare payments unless there is evidence of fraud.
- Medicare should be required to conduct a demonstration of evaluation and management documentation guidelines based on patient encounter time.
- Medicare should require carriers to issue written responses to physician questions that can be relied on during subsequent audits.
- Allow exhaustion of administrative appeals before physicians must repay an alleged overpayment.
"ACP-ASIM believes that it is time for Congress to introduce more due process rights and fairness into the Medicare claims payment review system so that the overwhelming majority of physicians and other health care providers, who are honest and law abiding, no longer have to suffer from onerous and unfair Medicare rules," said Dr. Hall.
American College of Physicians-American Society of Internal Medicine (ACP-ASIM) represents more than 115,000 physicians and medical students. It is the largest medical specialty society and the second largest medical organization in the United States.
Jack Pope, ACP-ASIM Washington Office, (202) 261-4556
Jennifer Whalen, ACP-ASIM Washington Office (202) 261-4575
Page updated: 11-03-03