Bill would curb Medicare agency's efforts to fight fraud

Backed by dozens of organizations representing physicians and other healthcare providers, a bipartisan group of House members and Senators introduced legislation Wednesday that would curb the ability of the Health Care Financing Administration to demand back payments from providers it says have overcharged Medicare.

"All of us here recognize the need to ferret out waste, fraud and abuse," said Sen. John Kerry, D-Mass., who is sponsoring the "Medicare Education and Regulatory Fairness Act" with Sen. Frank Murkowski, R-Alaska. "But we also have an obligation to ferret out stupidity and abusiveness."

Reps. Patrick Toomey, R-Pa., and Shelley Berkley, D-Nev., have introduced the bill in the House.

While the HCFA's efforts to curb waste are well-intentioned, said Toomey, "HCFA has imposed an unbearable burden on doctors who don't practice waste, fraud or abuse."

The measure would give healthcare providers new rights to appeal when Medicare demands repayments after audits. It would also limit the use of "extrapolation"--the program used to increase the amounts it wants repaid based on limited reviews.

Said Thomas Reardon of the American Medical Association, "This is similar to the IRS identifying an error on your most recent tax return and making the assumption that you made the same error on every return you ever filed--and then requesting back taxes on each and every return."

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