Please view our video link below and written update on Medicare Fraud &
Abuse.
Hearing on Medicare Fraud & Abuse
The House Ways and Means Health Subcommittee held a hearing this week on
oversight of the Medicare program, specifically targeting waste, fraud and
abuse. NAAOP attended this hearing for its members’ benefit. Unfortunately,
there was little recognition of the extreme pressures from Medicare auditing
and appeals delays that Medicare providers deal with on a daily basis.
The subcommittee called three witnesses to discuss action against Medicare
fraud. Gloria Jarmon, the Deputy Inspector General for Audit Services within
the Office of the Inspector General for the Department of Health and Human
Services, spoke about the need for the Centers for Medicare & Medicaid
Services (CMS) to reduce improper payments and improve oversight of
contractors. Kathleen King, the Director of Health for the Government
Accountability Office (GAO), spoke about the need for further action at CMS
on implementing strategies developed by the GAO. Finally, Dr. Shantanu
Agrawal, the new Deputy Administrator and Director of the Center for Program
Integrity at CMS, responded to criticism that the agency has not made
sufficient progress in fighting Medicare fraud, waste, and abuse.
Members of both parties showed their irritation with CMS through their
questions to the panel. Many lawmakers said the agency must show greater
commitment to tackling fraud. Subcommittee Chairman Kevin Brady (R-TX) ended
the hearing with a pledge to introduce legislation to address the problem,
saying that a recent report revealed that fraud costs Medicare more than $50
billion annually. However, the continuing burden on legitimate providers
from the Recovery Audit Contractor (RAC) program and the lengthy delay in
the Medicare administrative appeals process were not discussed during the
hearing.
NAAOP and the O&P Alliance will submit testimony for the written record to
the subcommittee about Medicare waste, fraud, and abuse. That testimony will
focus on building support for two legislative proposals that address waste,
fraud, and abuse from the perspective of legitimate O&P providers.
First, the “Medicare Orthotics and Prosthetics Improvement Act of 2013”
(H.R. 3112) would link the ability of providers and suppliers of O&P
services to be paid by Medicare to the level of education and training they
possess. The bill would finally implement regulations mandated by a
long-standing federal law that prohibits unqualified providers and suppliers
from receiving Medicare payment for custom orthotics and prosthetics. Recent
reports suggest that CMS fails to ensure that only licensed providers are
paid, and our testimony will highlight how fixing this problem is well
within reach and is long overdue.
Second, draft legislation known as the “Ensuring Beneficiary Access to
Orthotics and Prosthetics Act of 2014” contains a wide range of option that
would improve the Medicare administrative appeals process, reform the
Medicare Recovery Audit Contractors, and recognizes O&P practitioners as
professional providers of O&P care for purposes of demonstrating medical
necessity. Consult
information.
Please visit our website at: www.naaop.org
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