CONGRESS
OVERRIDES PRESIDENTIAL VETO TO STOP MEDICARE FEE SCHEDULE CUTS AND APPROVE
1.1% INCREASE FOR 2009
Hours after President Bush Tuesday vetoed
a bill that called for canceling a cut in doctors' Medicare pay, both houses
of Congress easily overturned the action and enacted the bill into law.
Sen. Max Baucus, Montana Democrat, shakes
hands with members of AARP during a rally to support enactment of a bill
ending a cut in doctors' Medicare pay. (Getty Images)
Mr. Bush "will have to explain to
America's seniors why he was so willing to stand between them and their
health care," said House Majority Leader Steny H. Hoyer, Maryland Democrat.
"But, thankfully, we don't have to take no for an answer."
The House voted 383-41 to override the
veto, more than the two-thirds majority needed to pass the bill. The House
in April initially passed the bill by a vote of 349-62.
Later Tuesday, the Senate followed suit,
voting 70-26 to override the veto. Twenty-one Republicans joined 47
Democrats and two independents in voting yes. No Democrats voted against the
measure.
The legislation scuttles a 10.6 percent
pay cut for doctors treating Medicare patients that kicked in July 1. Some
doctors have threatened to quit taking new Medicare patients if the cut was
allowed to stand.
The legislation would freeze Medicare
rates for doctors in 2008 and would increase them by 1.1 percent in 2009.
CMS: RAC program has recovered more than $1B
by Anne Zieger
CMS has released a new report stating that
Medicare has recovered more than $1 billion through the Recovery
Audit Contractor program since 2005, with 85 percent of the money
having been taken back from hospitals. When the costs of collecting
the money were taken into account--along with the small number of
refunds made to providers--CMS was able to return $693.6 million to
the Medicare trust fund.
In its analysis, CMS said that most of the improper payments made to
providers occurred due to billing and coding errors, frequently when
one procedure was billed repeatedly. Other problems discovered by
RACs included incorrect procedure codes and submission of duplicate
claims that both got paid. When the RACs challenged Medicare
payments, 14 percent of providers appealed, and 4.6 percent of those
decisions were overturned. (Bear in mind that this means that more
than 95 percent of providers lost
their appeal--and those were the ones who felt they had a strong
enough case to go through the appeals process!) Not surprisingly,
CMS acting administrator Kerry Weems called the results a success.
That being said, the report also notes that CMS has made some
significant changes to the program over time. For example, the
agency changed the amount of time a RAC could look back into old
provider records from a four-year window to three years. Still,
providers and Congressional legislators continue to criticize the
RAC program, which HHS is required to make a permanent, national
effort by Jan. 1, 2010.
Medicare | Medicare Audit Recovery Program Has Recovered $700M in
Overpayments to Providers
[Jul 14, 2008]
Private auditors over about three
years have recovered almost $700 million in Medicare overpayments to
hospitals and other health care providers in six states as part of a
recovery audit contractor program, the Wall Street Journal
reports. Under the program,
CMS pays auditors a
portion of the amount of improper Medicare payments that they identify.
Auditors reviewed $317 billion in Medicare claims and found $1.03
billion in improper payments, most of which involved claims filed in New
York, California and Florida. Medicare overpayments account for $992.7
million of the improper payments, and underpayments accounted for $38
million. The cost of the program amounted to about 20 cents per dollar,
with $187.2 million paid to auditors. Providers appealed 14% of the
alleged Medicare overpayments and successfully challenged about 4.6% of
the overpayments.
Tim Hill, CFO and director of the
Office of Financial Management at CMS, said, "All in all, we're very
happy with the results," adding, "It returned a lot of money to the
trust fund, particularly when you think that we're talking about three
states."
The program has "drawn fire" from providers, "who call it overly
aggressive and too confrontational," the Journal reports.
However, CMS has begun to expand the program nationwide. CMS plans to
revise the program to require auditors to use clinically trained
personnel to ensure that they evaluate medical necessity consistently
with other agency operations and to communicate with providers about
audits in more detail. In addition, CMS plans to add staff to oversee
the program and allow providers to track audits (Francis, Wall
Street Journal, 7/14).
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CNN Airs Segment on Chiropractic, Stroke; Second
Report to Air This Weekend
Over the past two years, there has been increasing media interest
in the topic of stroke following cervical manipulation. Most recently,
ACA has been intimately involved in two separate media reports from CNN. The
first segment aired Wednesday on CNN’s
American Morning and
featured ACA as the voice for the chiropractic profession. The main focus
of the segment was the story of Britt Harwe, who says she suffered a stroke
following chiropractic manipulation. During the interview, Harwe placed considerable emphasis
on the need for improved informed consent and transparency in
differentiating doctors of chiropractic from medical doctors.
CNN is also scheduled to air a segment this weekend on the program
House Call with Dr. Sanjay Gupta. Again, ACA has actively been
providing the show’s producers with information and has arranged for Dr.
William Lauretti, an assistant professor at NYCC and ACA spokesperson, to
conduct a one-on-one interview with Dr. Gupta.
House Call
airs from 8:30 – 9 a.m. ET on both Saturday and Sunday.
State associations and doctors of chiropractic are urged to be prepared
to respond to questions from concerned patients who might see or hear about
the story. ACA is providing a number of resources regarding the topic
of chiropractic and stroke at
www.acatoday.org/resources.
Courtesy of ACA Website |
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