CMS Delays Final Rule on Collecting Medicare Overpayments

On Tuesday, February 17, CMS announced through the Federal Register that it will postpone until February 16, 2016 the implementation of a proposed rule that would require Medicare providers under Parts A and B of Title XVIII to return overpayments within 60 days.

CMS first proposed the rule, which includes substantial sanctions for providers that fail to repay Medicare overpayments within 60 days, in February 2012.  The proposed rule also includes a 10-year look-back period during which providers are responsible for keeping track of claims and checking for any overpayments.

CMS justified the one-year implementation delay on the basis of “exceptional circumstances” regarding the “complexity of the rule and scope of comments.” Despite the delay, providers must continue to return overpayments under the existing rule.  CMS has attempted to change the overpayment regulations in the past. The agency proposed overpayment rules in 1998 and 2002, but neither rule was finalized.

Emergency Services Bill Introduced in the House

Late last week, Rep. Charlie Dent (R-PA) introduced legislation that would amend the Emergency Medical Treatment and Labor Act (“EMTALA”) to extend liability protections to on-call and emergency room physicians.  The bill (H.R. 836) is intended to ensure that federally mandated emergency services furnished by a hospital would be covered in the same manner as Community Health Centers. The emergency services legislation has been introduced in past sessions of Congress.  In 2012, the House version of the bill (H.R. 157) was approved by voice vote as an amendment to a larger bill (H.R. 5), but the Senate did not take action on the measure.

Ryan Discusses ACA Replacement Options

House Ways and Means Chairman Paul Ryan (R-WI) has indicated plans to unveil a Republican health care plan by the end of March.  The plan would come in advance of a Supreme Court ruling in June that could cripple the Affordable Care Act.  In January, House Majority Leader Kevin McCarthy (R-CA), appointed lawmakers, including Ryan, to conduct a working group to come up with a comprehensive alternative to the ACA.  Similar discussions are taking place in the Senate.

Bills Introduced This Week

Rep. Aaron Schock (R-IL) introduced a bill (H.R. 977) enabling hospital-based nursing programs to maintain payments under Medicare to hospitals for the cost of the nursing programs.

In the Senate, Sen. Chuck Schumer (D-NY) introduced a bill (S. 488) that would allow physician assistants, nurse practitioners and clinical nurse specialists to supervise cardiac, intensive cardiac and pulmonary rehabilitation programs.

Next Week in Congress

The House and Senate return next week.  On February 26, HHS Secretary Sylvia Mathews Burwell will testify before the House Energy and Commerce’s Health subcommittee regarding the department’s fiscal year 2016 budget.

Despite the hearing’s focus on the HHS budget, lawmakers will question Burwell on a range of issues, including the administration’s contingency planning should it lose the King v. Burwell case and Obamacare tax credits become blocked in federal exchange states.