Legislative Update for Week Ending July 11, 2014

Legislative Update for Week Ending July 11, 2014

This week, the Senate Special Committee on Aging released a new report on improper payments within the Medicare program, and lawmakers held a hearing to discuss the findings on Wednesday. In addition, The Senior Citizens League (TSCL) saw three key bills gain support.

Aging Committee Finds Record-High Medicare Payment Errors

On Wednesday, the Senate Aging Committee released a new report revealing that improper payments increased from 8.5 percent in 2012 to 10.1 percent in 2013 – a record-high for the Medicare program. At a hearing to discuss the report’s findings, lawmakers repeatedly said that the Centers for Medicare and Medicaid Services (CMS) is not doing enough to fix the growing issue, even though the agency hired more recovery audit contractors (RACs) than ever before last year.

Sen. Bill Nelson (FL), Chairman of the Aging Committee, stated: “The bottom line is, despite doing more audits than ever before, Medicare just isn’t getting the job done when it comes to preventing payment errors. Medicare must change the way it pays its providers so that the cheats are getting caught and the honest providers are getting paid.”

According to the report, the current system for auditing Medicare payments is “duplicative and poorly coordinated.” In addition, it places “an undue burden on providers,” who are often found to be innocent of fraud, but are left with damaged businesses. Lawmakers on the Committee said this occurs because RACs are compensated based on the volume of improper payments that they identify, so they often launch serious investigations into very minor mistakes. This strategy fails to address the greater issue.

The Committee recommended that CMS move away from a “pay and chase” method towards a more proactive approach. Lawmakers suggested that RACs be compensated based on their ability to prevent improper payments, instead of their ability to recover past payments. They also recommended that RACs focus on providers who have filed improper claims in the past, and that coordination between RACs should increase so that claims will not be audited more than once.

The Committee noted that they will be requesting regular reports from CMS in the future to ensure that improvements are being made. In the coming months, TSCL will be sure to keep an eye out for any updates, and we will continue to advocate for legislation that aims to prevent and reduce fraud, waste, and abuse within the Medicare program.

Three Key Bills Gain Support

This week, one new cosponsor – Rep. Mo Brooks (AL-5) – signed on to the No Social Security for Illegal Immigrants Act (H.R. 2745). The total is now up to twenty-nine. If signed into law, the bill would prevent Social Security credits from being earned by work done illegally. Currently, those who receive “green cards” or work authorization may file a claim for Social Security benefits based on all earnings – even earnings from jobs where they used stolen, invalid, or fraudulent Social Security numbers. To protect the integrity of the Social Security program, TSCL believes this practice must be put to an end.

In addition, one new cosponsor – Rep. Keith Rothfus (PA-12) – signed on to the Improving Access to Medicare Coverage Act (H.R. 1179), bringing the total up to one hundred and fifty-three. If signed into law, H.R. 1179 would amend current Medicare policy to count hospital stays under “observation status” towards the three-day requirement for skilled nursing care. Currently, those under “observation status” don’t qualify for coverage of the benefit, and they are often hit with large, unexpected bills after receiving necessary medical care.

Finally, Rep. John Shimkus (IL-15) signed on to the Social Security Fairness Act (H.R. 1795), bringing the total up to one hundred and twenty-three. If signed into law, the Social Security Fairness Act would repeal the Government Pension Offset (GPO) and the Windfall Elimination Provision (WEP) – two federal provisions that unfairly reduce the earned Social Security benefits of millions of teachers, fire fighters, peace officers, and other state or local government employees each year.

TSCL enthusiastically supports H.R. 2745, H.R. 1179, and H.R. 1795, and we were pleased to see support grow for each one this week.