Fair Medical Audits Act of 2015
Latest action · Jun 3, 2015 Referred to the Subcommittee on Health.
Progress
Where this bill reached, and when. A stage with no date was not reached; one that failed a vote and later carried shows the date it carried.
- IntroducedMay 22, 2015
- Passed HouseNot reached
- Passed SenateNot reached
- To the PresidentNot reached
- Became lawNot reached
Summary
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.
Cosponsors 24
Members who signed on, in the order they did. Signatures ran from May 22, 2015 to Feb 1, 2016; 1 is an original cosponsor, there from the day it was introduced.
| Seat | Cosponsor | Signed on | |
|---|---|---|---|
| R-CA | Devin Nunes | Original | May 22, 2015 |
| R-TN | David P. Roe | Jun 9, 2015 | |
| R-GA | Earl L. "Buddy" Carter | Jun 23, 2015 | |
| R-WA | Cathy McMorris Rodgers | Jul 13, 2015 | |
| R-NC | Mark Meadows | Jul 13, 2015 | |
| R-CA | Doug LaMalfa | Jul 15, 2015 | |
| R-GA | Austin Scott | Jul 21, 2015 | |
| R-TN | Diane Black | Jul 29, 2015 | |
| R-SC | Jeff Duncan | Jul 29, 2015 | |
| R-NY | Chris Collins | Jul 31, 2015 | |
| R-GA | Lynn A. Westmoreland | Sep 8, 2015 | |
| R-TN | Marsha Blackburn | Sep 8, 2015 | |
| R-TX | Brian Babin | Sep 18, 2015 | |
| R-CA | Stephen Knight | Sep 18, 2015 | |
| R-CA | Paul Cook | Sep 24, 2015 | |
| R-NC | David Rouzer | Sep 29, 2015 | |
| R-WV | Evan H. Jenkins | Oct 6, 2015 | |
| R-GA | Jody B. Hice | Oct 20, 2015 | |
| R-SC | Joe Wilson | Oct 29, 2015 | |
| R-TX | Blake Farenthold | Nov 16, 2015 | |
| R-TX | Ted Poe | Nov 19, 2015 | |
| R-CA | Edward R. Royce | Dec 1, 2015 | |
| R-TX | Roger Williams | Dec 2, 2015 | |
| R-TX | John Ratcliffe | Feb 1, 2016 |
Committees 2
Where it was sent and what each committee and subcommittee did with it, in order.
| Chamber | Committee | What it did |
|---|---|---|
| House | Ways and Means Committee | Referred May 22, 2015 |
| Health Subcommittee | Referred Jun 3, 2015 | |
| House | Energy and Commerce Committee | Referred May 22, 2015 |
| Health Subcommittee | Referred May 29, 2015 |
Actions 4
Everything that happened, newest first.
- Jun 3, 2015Referred to the Subcommittee on Health.
- May 29, 2015Referred to the Subcommittee on Health.
- May 22, 2015Introduced in House
- May 22, 2015Referred 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.
In the Congressional Record 1
Days the Record’s own index lists this bill, newest first, with the pages and the members it names. Pages starting H are the House, S the Senate, E Extensions of Remarks.
| Where | In the Record | Members | Date |
|---|---|---|---|
| House | Lists H3574H.R. 2568–2573 | — | May 22, 2015 |
Research
What has been written about this bill: committee reports, cost estimates, the sponsor’s authority statement, printed hearings and the Congressional Research Service’s work.
Constitutional authority
The sponsor’s statement, as printed in the Congressional Record, vol. 161, no. 80, May 22, 2015, page H3574.
Titles 2
Every title it has carried, official and short, at each stage.
- Official Title as Introduced
- To amend title XVIII of the Social Security Act to improve the process of audits by recovery audit contractors and the recovery of overpayments under the Medicare program.
- Short Titles as Introduced
- Fair Medical Audits Act of 2015
Subjects
Assigned by the Library of Congress. Policy area: Health.
Text 1
Each version as it was printed, newest first.
- May 22, 2015Introduced in House
Everything here is as published by Congress: the summary is the Congressional Research Service's, the action wording is the clerks', and the subjects are the Library of Congress's. How far it got is read from the actions themselves, taking the most recent one of each kind, so a bill that failed a vote and later passed is shown as having passed. Records come from this bill on Congress.gov and govinfo.gov; cost estimates are the Congressional Budget Office's, and the hearings are the printed hearings GovInfo publishes, which can appear months after the hearing.
