House Unanimously Backs Medicare Reform Bill

Legislation that would ease the many unreasonable burdens on physicians who participate in Medicare was passed by the House of Representatives last month by a vote of 408 to 0. At press time, APA was working with key legislators to get the Senate to pass the bill, known as the Medicare Regulatory and Contracting Reform Act (HR 3391), before the holiday recess. The AMA also supports its passage.

The bill, introduced by Rep. Nancy Johnson (R-Conn.), would limit the number of Medicare regulations issued, lessen physician paperwork, and give Medicare administrators greater contracting flexibility.

The reform legislation is a merger of two bills (HR 2768 and HR 3046) that were approved by their respective House committees in October (Psychiatric News, December 7, 2001).

The consensus bill does the following:

• Limits the publication of new Medicare regulations to once a month.

• Requires a new comment period for provisions in final rules that were not included in proposed rules.

• Prohibits the retroactive application of regulatory policy changes unless the secretary of Health and Human Services (HHS) decides it meets the mandated criteria.

• Requires Medicare carriers to give physicians prompt written guidance that they can use if they are audited. If the HHS secretary decides that the guidance is inaccurate, the physician cannot be penalized.

• Limits the use of the method (known as the extrapolation method) by which the government determines how much a physician owes in cases involving high rates of billing errors.

• Requires Medicare carriers to notify physicians at least 45 days in advance of being audited.

• Allows physicians deemed to have been overpaid by Medicare to repay the difference over three years rather than 30 days.

• Requires Medicare carriers to educate physicians about coding and other requirements.

The full text, summary, and status of the Medicare Regulatory and Contracting Reform Act can be accessed on the Web at http://thomas.loc.gov by searching on “HR 3391.” ▪