POLICY BRIEFINGS


CMS MPPR Policy Criticized


In a CMS rule proposed in July, the agency said it would expand the so-called multiple procedure payment reductions (MPPR) policy to the technical component of certain cardiovascular and ophthalmology diagnostic services resulting in a 25% reduction for services beyond the initial service on the same day.  Sixty House members sent a letter to CMS asking the agency to withdraw this component because, according to the members, the policy would create financial disincentives for specialists providing care for seniors.


Senators Seek Release of FPS Report


Senators Orrin Hatch and Tom Coburn sent a letter to CMS asking the agency to release within three days a report due October 1st on the fraud prevention system (FPS) which CMS established in 2011 to predict fraud among Medicare fee-for-service claims.  The senators said they are concerned that the system has not been effective in carrying out its mission to detect fraud.  Also of note, Rep. Sam Graves introduced H.R. 6575, legislation that would limit the documentation requests that Medicare contractors can make of hospitals when investigating potential Medicare fraud.


Meaningful Use Payments Top $7 Billion


CMS announced that health care providers who demonstrate meaningful use of certified EHR systems have qualified for $7.7 billion in incentives to date, as follows: $4.8 billion to eligible hospitals; $1.4 billion to Medicare eligible health care professionals; and $1.2 billion to Medicaid eligible professionals.  In related news, Senators John Thune, Tom Coburn, Richard Burr and Pat Roberts sent a letter to HHS Secretary Kathleen Sebelius for a briefing on the meaningful use program and its impact on health care spending.  They asked for answers to the following questions: is the EHR incentive program resulting in higher utilization of diagnostic testing and what is the Administration’s strategy for addressing any higher health care spending as a result of EHR adoption; have some providers received federal EHR incentives for technology they adopted prior to the meaningful use program and how will the Administration recoup improper payments to program participants; has EHR use among providers resulted in higher Medicare billings; and what is the Administration’s strategy for interoperability.


Recently Introduced Health Legislation


H.R. 6573 (HUMAN ORGANS TRAFFICKING), to combat trafficking in human organs and for other purposes; ROS-LEHTINEN; to the Committee on Foreign Affairs, Oct. 12.

H.R. 6575 (MEDICARE), to amend Title XVIII of the Social Security Act to improve operations of recovery auditors under the Medicare Integrity Program, to increase transparency and accuracy in audits conducted by contractors, and for other purposes; GRAVES of Missouri; jointly, to the committees on Ways and Means and Energy and Commerce, Oct. 16.



October 22, 2012: | Page 1 Page 2

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