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Bull's Eye: HCFA

Washington -- It appears the home health lobbying efforts are starting to have an effect in Congress.

Soon after the House of Representatives unveiled its initiative to revamp the procedures and regulations used by the Health Care Financing Administration, Sens. Frank Murkowski, R-Alaska, and John Kerry, D-Mass., introduced the Medicare Education and Regulatory Fairness Act, which aims to streamline the bureaucratic bog hampering the Medicare reimbursement system.

"Seniors are being told that their insurance is simply not wanted," Murkowski said. "The reason is because we have built up a system designed to block care and micromanage health care. Providers can't afford to keep up with the seemingly endless regulations or deal with the penalties if they ever make a mistake. We simply have to reform this process for everyone's benefit."

Major components of the bill include:

  • Allowing providers to contest an overpayment determination and submit additional information, without waiving their appeal rights;

  • Establishing a health provider's right to challenge HCFA regulations;

  • Prohibiting HCFA's recovery of past overpayments by withholding future payments and requiring HCFA to set up repayment schedules to offset billing errors; and

  • Prohibiting, when no fraud is shown, the prosecution of providers that voluntarily disclose overpayments and return such payments within one year.

"Health care professionals are the backbone of our health care network," Murkowski added. "When our seniors need care, it is the provider who heals, not the health insurer or the government. But more and more often, seniors are being told that health care professionals won't accept Medicare. That is especially the case in rural areas, where the number of physicians already is quite limited.

"This bill will allow providers to practice medicine without fearing the threats, intimidation and aggressive tactics of a faceless bureaucratic machine," he continued. "Most importantly, it will reform the flawed appeals process that now often intimidates health care professionals, causing our seniors to suffer in the end."

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