New user fees to finance fraud and abuse probes
New user fees to finance fraud and abuse probes
Tucked away in President Clinton’s 2,600-page federal budget proposal for fiscal year 2000 are some $200 million in new annual user fees that would be charged to providers participating in the Medicare program. The money would finance a Health Care Financing Administration (HCFA) effort to double the number of audits and medical reviews it conducts of provider claims. The overall goal is to reduce inappropriate payments, as well as underwriting the launch of the new Medicare+Choice program.
This marks a new emphasis that HCFA sources say will focus more attention on prepayment audits than on post-payment reviews.
Last year, HCFA tried to inaugurate a similar set of user fees, only to see Congress cut them out of its final budget in response to intense opposition from provider groups. "Like last year, we’ll fight the institution of these user fees," says Dennis Barnhardt, communications director for the Englewood, CO-based Medical Group Management Association.
Under the proposed user fees:
Physicians, other providers, and suppliers would be charged a registration fee to participate in the Medicare program. That would produce $20 million. Providers would be charged $1 for each claim submitted on paper rather than electronically, raising $55 million, and $1 for each duplicate and unprocessable claim submitted, producing $17.8 million.The president’s proposed budget also projects saving $2.9 billion over five years through implementation of various measures to cut waste, fraud, and abuse in federal health programs.
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