Coalition: Omnibus Bill Too ‘Sympathetic’ to Industry Responsible for Billions in Medicare Waste

December 15, 2014

Kristin Walter
(202) 898-0995

Washington, D.C. – The American Coalition for Healthcare Claims Integrity (ACHCI) issued a statement today regarding provisions in the Omnibus spending package that pertain to Recovery Audit Contractors and improvements to the ALJ hearing backlog.

“Our coalition is pleased to see language in the omnibus spending package that calls for greater transparency and a consistent application of Medicare policy in the appeals process. While Recovery Auditors maintain a 96% accuracy rate, this has not prevented ‘frequent flier’ providers from clogging the ALJ process in an attempt to game the system – while at the same time bemoaning the backlog they helped to create.

“We are disappointed that the bill contains language sympathetic to an industry responsible for incorrectly billing Medicare $46 billion in FY2014 alone. We are also troubled by other provisions that will take Medicare integrity initiatives in the wrong direction and divert attention from the seriousness of improper payments in the program. The directives to CMS in this bill amount to nothing less than the bullying of a federal agency by a trillion-dollar hospital industry committed to dismantling one of the nation’s most effective oversight programs.

“Despite provider protestations to the contrary, the greatest risk to patient care is Medicare’s looming insolvency, which will put at risk millions of American seniors who count on the program every day. Meanwhile, providers continue to improperly bill Medicare at staggering rates while advocating for less transparency and a hands-off approach to government oversight.

“We look forward to continuing our efforts to educate and inform lawmakers and American seniors in 2015 about the effectiveness of Recovery Auditors and the ongoing threats to the program posed by improper billing and the influence of the provider industry.”

For more information, please visit: www.properpayments.com


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