Medicare Contractor, Audit Reform Bill May Hit ‘Trouble’

The House Energy and Commerce health subcommittee on Oct. 17 passed a bill (HR 3046) by voice vote that would reform Medicare's contracting system and provide "regulatory relief" to providers, but a series of amendments may pose "trouble" when the full committee addresses the legislation, CongressDaily reports (Rovner, CongressDaily, 10/17). Under the bill, Medicare officials could only issue regulations one time per month and could not make "substantive policy changes" retroactive. The legislation would also allow providers 30 days to "come into compliance" with new rules and would establish a panel of judges who would hear only Medicare cases and would create an "expedited process" for providers. In addition, the legislation would require improved education and outreach for providers and prohibit punishment for providers who "reasonably rely on written contractor guidance" that "turned out to be incorrect." The legislation also would give Medicare officials more authority to select contractors (Kaiser Daily Health Policy Report, 10/3). Several members of the subcommittee offered and withdrew amendments "only tangentially related" to the legislation, provisions that the full committee will have to address. Rep. Charlie Norwood (R-Ga.) said that the bill would not "go far enough" to address provider concerns about Medicare officials and contractors. Norwood has proposed an amendment that would "make it more difficult" for CMS to use "extrapolation" to determine the amount providers owe to the government in overpayments. In addition, Norwood proposed an amendment to require that only physicians "adjudicate 'medical necessity' claims." Norwood has also proposed an amendment to strike a part of Medicare law that prohibits providers from treating family members. Norwood said, "Are we so fearful that doctors will get together in a room with their mothers and say 'I'm going to file a false claim. Mom, you back me up?" CongressDaily reports that members of the House Energy and Commerce committee "hope to work things out" before the full committee meets (CongressDaily, 10/17).