An effort by two congressmen to ease administrative burdens for skilled nursing providers is garnering applause from the industry this week.
Reps. Kevin Brady (R-TX) and Peter Roskam (R-IL) recently sent a letter to the head of the Centers for Medicare & Medicaid Services, urging Administrator Seema Verma to cut red tape for nursing homes and other providers. More specifically, the two members of the House Committee on Ways and Means pointed to consolidated billing as an ongoing headache for nursing homes.
The Balanced Budget Act of 1997 requires SNFs to submit Medicare claims for all services that their residents have received. Certain services have been excluded from that list, to be separately covered under Medicare Part B, to ensure that SNFs aren’t forced to absorb high-cost services that patients may need. That list has expanded over time, causing confusion for providers and accountants, the congressmen noted.
“SNFs and certified public accounting firms preparing consolidated billings state that they face backlogs and contradictory CMS interpretations of excluded and non-excluded items,” the two congressmen wrote Tuesday. “We urge CMS to take steps to streamline consolidated billing processing and clarify policies to reduce time lost on paperwork when such resources could instead be diverted to patient care.”
The American Health Care Association applauded those efforts in a statement issued Thursday.
“We appreciate the committee for recognizing the concerns related to consolidated billing,” said Clifton Porter II, senior vice president of government relations for the association. “When PPS was initiated in 1997 the clinical complexity of our patients and residents was very different than it is today. Encouraging CMS to update current standards relating to medication exclusions to be consistent with today’s patient needs is both good public policy and most importantly good for patient care.”
Brady, who is chairman of the Ways and Means Committee, and Roskam also sent separate letters on additional ways to cut red tape for hospitals and for physicians. The letters follow a report, issued last month, tied to the committee’s “Medicare Red Tape Relief Project.