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Last week, the House Energy and Commerce Committee Health Subcommittee unanimously passed a Medicare regulatory relief bill that targets the program’s complex regulatory system by improving communication between it and providers, creating an expedited process for appeals to claim denials and improving education and training for Medicare contractors. That comes just weeks after the House Ways and Means Health Subcommittee passed a similar measure.
Mary Grealy, president of the Healthcare Leadership Council, gives the bill good odds. "It was extraordinary to see this done in a bipartisan way," she says. Health care representatives would like to see a bill that goes even further, she adds. But eliminating the more controversial provisions has improved the bill’s chances by getting both sides of the aisle on board behind the bill. The reforms also are championed by Centers for Medicare and Medicaid Services (CMS) Administrator Tom Scully.
Vicki Riley, a spokeswoman for the Commerce Committee, says talks have commenced between that committee and the House Ways and Means Health Subcommittee to hammer out differences between the two versions. In addition, she reports that talks already are under way with the Senate Finance Committee. "We want to get something passed this year," she asserts. "CMS agrees this is an issue that really needs to be taken care of now," she adds. "I think it has a pretty good chance of passing."
According to Grealy, changes to the current provider appeals process are critical. Any reforms to overpayment review and how Medicare contractors deal with payment errors and audits also would be extremely welcome, she adds. "Anything you do to simplify this program is going to make it easier for providers to spend less time on paperwork and more resources on patient care," she says.
Here is a rundown of some of the key reforms included in the House Commerce legislation: