Senate Finance Committee Approves Legislation Reforming Medicare Audit & Appeal System

Posted on Tuesday, June 9, 2015 2:39 PM

The Senate Finance Committee passed out of committee the Audit & Appeal Fairness, Integrity, and Reforms in Medicare (AFIRM) Act of 2015, which would reform the Medicare audits and appeals process. NAHC has submitted recommendations for the Committee to consider in developing legislation to reduce faulty claims denials and the resulting plethora of appeals. Senate leaders have called the bill “an important step toward streamlining the Medicare audit and appeals process to help healthcare providers better service millions of patients across the nation. This is a common sense bill that will help untangle the web of red tape that ensnares the current audit and appeals process and guarantees Medicare patients continue to have access to high-quality care.” The legislation would provide more resources by requiring appropriations of $125 million per year to the Office of Medicare Hearings and Appeals and $2 million per year to the Departmental Appeal Board of HHS in order to conduct reviews, hearings, and appeals. Additionally, the bill establishes a new track for less costly and less complex cases, and a settlement process for appellants, beginning in 2017. Click here to read more.    

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