On April 30, Representatives Sam Graves (R-MO) and Adam Schiff (D-CA) introduced legislation known as House of Representatives (H.R.) bill 2156, with the official title To amend title XVIII of the Social Security Act to reform the practices of recovery audit contractors under the Medicare program, and for other purposes. This bill would change the Recovery Audit Contractor (RAC) payment structure from the current contingency payment structure to a flat fee; impose penalties against RACs if a significant number of their claims are overturned during the appeals process; lower payments to RACs for poor performance; allow hospitals to rebill claims when appropriate; and require RACs to base their inpatient claims decisions on only the information available to the physician at the time of the patient visit, reported the American Hospital Association (AHA), which supports the legislation.
A similarly titled bill with a focus on O&P, H.R. 1526, the Medicare Audit Improvement Act of 2015, was introduced by Representative Mark Meadows (R-NC) on March 23. That bill was introduced to modify policies relating to payment under the Medicare program for durable medical equipment, orthotics and prosthetics, and prosthetic devices, and for other purposes.
