The Health Care Policy Blog is a forum for health care policy professionals
and Bloomberg BNA editors to share ideas, raise issues, and network with
Thursday, June 7, 2012
by James Swann
Medicare and Medicaid regulations have grown increasingly
bulky and burdensome, a hospital trade group recently said, and it’s time for
Congress to step in and make things right. I recently wrote about a letter to Congress from the American Hospital Association expressing worry over the expanding number of CMS program
integrity contractors and the resulting number of hospital audits. In many
cases, the AHA said multiple contractors are investigating the same claim, and
hospitals are forced to divert time and resources that could better be used on
New regulations from Congress should require CMS to cut back
on duplicate audits and streamline the entire contractor program, the AHA said.
Congress should also refocus CMS efforts on stopping improper payments, not
denying otherwise valid claims for technical reasons. For example, CMS
contractors currently deny claims if they’re billed as inpatient when the
service was really outpatient, even if the service was legitimate and
necessary. Congress could fix this by requiring CMS to let hospitals re-bill
claims under the right patient setting, the AHA said.
to post a comment.
Impact of Sequestration on Life Sciences--FDA Can't Travel(1)
Senate On Verge of Approving Tavenner Nomination
HHS Issues Streamline Applications For Health Coverage
Practical Guidance is the Name of the Game for OIG Exclusion Bulletin
Will Sunshine Act Put a Freeze on Health Care R&D?