House-Senate Conference Agrees on Physician Regulatory Relief
Conferees have begun working to reconcile differences in the House and Senate Medicare bills. The first issue taken up involves one of long-standing interest to physicians: Regulatory relief.
On July 25th, conferees announced that they had reached agreement on the regulatory relief provisions. Conference Chair Representative Bill Thomas (R-CA) said,"Physicians are spending too much time struggling with paperwork and not enough time on patient care."
While exact details of the language to be included in the final conference report is not yet known, the agreement reached by the Conferees will;
l. Limit the use of the process of extrapolation to only those cases where there is a sustained or high payment error rate or documented education efforts have failed.
2. Eliminate penalties and interest for physicians faced with alleged overpayments who have relied on written guidance from Medicare.
3. Educate physicians about incorrect billing practices and allow an opportunity to correct errors before repayment demands are made.
4. Delay repayment demands until physician appeals have been considered.
5. Offer physicians installment plans for repayment instead of withholding payment of their claim.
6. Ensure that any new documentation guidelines for evaluation and management codes are thoroughly pilot tested before they can be implemented as national policy.
7. Prohibit retroactive application of Medicare rules.
8. Require carriers to provide physicians with clear, concise, and accurate answers to their billing questions.
9. Ensure that prepayment reviews are terminated in a timely manner instead of continuing endlessly.
10. Give physicians the right to appeal if their application for a Medicare billing number is denied.
11. Ensure that services furnished under the prudent layperson standard and according to EMTALA requirements are covered by Medicare.
Staff and Members of Congress will be working throughout the August recess in an attempt to resolve the other numerous issues that are still in dispute between the House and Senate bills. Staff will be doing the bulk of the work, but Members are expected to be available during August as their input and approval is needed. The schedule for Conferees this week includes work on the prescription drug card provisions. Members are expected to resolve outstanding issues by Sept. 13th.
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