Medicare auditors would boost outreach and education efforts to long-term care and other providers under the provisions of a draft bill introduced Thursday by Rep. Kevin Brady (R-TX), chairman of the Ways and Means health subcommittee.
Long-term care providers will feel some effects but should not experience serious disruptions due to the shutdown of the federal government, according to prominent trade associations.
Medicare Administrative Contractors started a manual review process for outpatient therapy claims too quickly, setting the stage for chaos in late 2012, a government review has revealed.
The Centers for Medicare & Medicaid Services should move faster to make changes based on Medicare audits and should have more direct oversight over Medicaid, according to bipartisan legislation introduced Tuesday. "The Preventing and Reducing Improper Medicare and Medicaid Expenditures Act of 2013" proposes a variety of reforms to cut down on waste, fraud and abuse. The PRIME Act was introduced by Sens. Tom Carper (D-DE) and Tom Coburn (R-OK), and Reps. John Carney (D-DE) and Peter Roskam (R-IL).
Therapy providers should review therapy cap denials for 2013 and refund any beneficiary payments for these services, according to a Medicare newsletter released Thursday.
As part of its pushback against the manual review process for therapy claims, the American Health Care Association has launched a clearinghouse to gather provider feedback. AHCA President Mark Parkinson described the RAC-led review process as "bifurcated, confusing and wholly inappropriate" in a four-page letter sent to Acting CMS Administrator Marilyn Tavenner last week.
Providers will have their say about the future of Medicare Administrative Contractors.
The Medicare contractors keeping close tabs on long-term care facilities will be subject to oversight too, according to a federal working plan released this week.