US Congress House Bill 2568 (Prior Session Legislation)

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Spectrum: Partisan Bill (Republican 25-0)
Status: Introduced on May 22 2015 - 25% progression, died in committee
Action: 2015-06-03 - Referred to the Subcommittee on Health.
Pending: House Subcommittee on Health Committee
Text: Latest bill text (Introduced) [PDF]

Fair Medical Audits Act of 2015 This bill amends title XVIII (Medicare) of the Social Security Act to modify requirements related to the identification and recovery of overpayments under Medicare. A contract between the the Centers for Medicare & Medicaid Services (CMS) and a recovery audit contractor must require the contractor to provide a health care provider with: (1) specified identifying, legal, and logistical information; (2) an identification of any errors or underpayments discovered in the audit; and (3) a description of how any requested overpayment amount was calculated. Standards for extrapolation when used to determine overpayment amounts are established. CMS must require a contractor to give a provider at least 90 days' notice of identified code over-utilization and to reimburse a provider for the cost of producing certain documentation. The retrospective audit period is limited to two (rather than four) years. Recovery audit contractors must have staff with knowledge and experience related to clinical licensure and medical records, claims, and codes. A contractor that has excessive overturned determinations shall be subject to administrative penalty and, under specified circumstances, liable for attorneys' fees. In the case of a provider seeking reconsideration of an overpayment determination, CMS may not recoup the overpayment until a decision has been rendered at the third level of appeal by an Administrative Law Judge. A recoupment based on a decision that is reversed on appeal must be returned to the provider within 30 days.

Fair Medical Audits Act of 2015

Rep. George Holding [R-NC]	Rep. Devin Nunes [R-CA]	Rep. David Roe [R-TN]	Rep. Earl Carter [R-GA]
Rep. Cathy McMorris Rodgers [R-WA]	Rep. Mark Meadows [R-NC]	Rep. Doug LaMalfa [R-CA]	Rep. Austin Scott [R-GA]
Rep. Jeff Duncan [R-SC]	Rep. Diane Black [R-TN]	Rep. Chris Collins [R-NY]	Rep. Lynn Westmoreland [R-GA]
Sen. Marsha Blackburn [R-TN]	Rep. Brian Babin [R-TX]	Rep. Stephen Knight [R-CA]	Rep. Paul Cook [R-CA]
Rep. David Rouzer [R-NC]	Rep. Evan Jenkins [R-WV]	Rep. Jody Hice [R-GA]	Rep. Joe Wilson [R-SC]
Rep. Blake Farenthold [R-TX]	Rep. Ted Poe [R-TX]	Rep. Edward Royce [R-CA]	Rep. Roger Williams [R-TX]
Rep. John Ratcliffe [R-TX]

Date	Chamber	Action
2015-06-03	House	Referred to the Subcommittee on Health.
2015-05-29	House	Referred to the Subcommittee on Health.
2015-05-22	House	Referred to House Energy and Commerce
2015-05-22	House	Referred to House Ways and Means
2015-05-22	House	Referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
2015-05-22	House	Introduced in House

Type	Source
Summary	https://www.congress.gov/bill/114th-congress/house-bill/2568/all-info
Text	https://www.congress.gov/114/bills/hr2568/BILLS-114hr2568ih.pdf