AMA Wire

Wednesday, May 9, 2012

This Week's News

Medical associations oppose onerous Medicare overpayment regulation

Medical associations oppose onerous Medicare overpayment regulation

A rule proposed recently by the Centers for Medicare & Medicaid Services (CMS) would create a number of taxing administrative requirements for physicians, including an obligation to identify overpayments that occurred during the last 10 years.

In a letter addressed to acting CMS Administrator Marilyn Tavenner, the AMA and more than 100 other medical associations called the proposal an "unprecedented burden" and urged the agency to make drastic revisions so physicians would be better positioned to comply. In particular, the associations contested the proposal's requirement that physicians must look through 10 years of files to determine whether an overpayment occurred.

The groups describe the measure as "extreme" and note that such a long look-back period generally would cover a transition from paper to electronic records and updated billing codes. That means many physicians would need to adopt multiple methods to review their files and cross-reference code sets. In place of this, the associations are recommending that the agency adopt a period no longer than three years, consistent with CMS's existing overpayment initiatives.

According to the letter, the review would be "a daunting task for a few year period, and an insurmountable burden for a 10-year period."

Among other petitions, the letter asks CMS to eliminate the requirement for physicians to search proactively for overpayments. The letter also urges CMS to establish a process for physicians to appeal potentially erroneous overpayment determinations.

Read more in a story in American Medical News.