Medicare Compliance & Reimbursement

It only seems like it’s once a month that the House votes to streamline Medicare regulations. Actually, it’s more like once a year that the House passes Medicare regulatory and contracting reform, which has so far nevertheless failed to be brought up on the Senate floor. The House Ways and Means Health Subcommittee March 20 unanimously approved a bipartisan bill similar to the one they passed last year.

The measure they approved, developed by Chair Nancy Johnson (R-CT), moves administrative law judges that hear Medicare appeals from the Social Security Administration to the Department of Health and Human Services, but not to the Centers for Medicare & Medicaid Services. An earlier version had directed HHS to assure the ALJs’ independence from CMS, but in a bid to allay continuing concerns the new bill would place the judges “in an administrative office that is organizationally and functionally separate from CMS.”

The measure, H.R. 810, contains many provisions augmenting provider rights regarding payment monitoring and disputes. It sets deadlines that CMS must adhere to in moving from proposed to final rules, mandates additional comment periods for portions of final regulations that do not represent “logical outgrowths” of earlier rulemaking stages, and prevents substantive regulatory changes from becoming effective until 30 days after they are announced.