Medicare Audit Improvement Act of 2015
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HR 1526 — Medicare Audit Improvement Act of 2015
Last action — Referred to the Subcommittee on Health.
No card. One bill, free forever — alerts when it moves.
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✓Introduced
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✓In Committee
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Died in session
This bill died with 114th Congress. It reached “In Committee” and never advanced before the session ended, so it can no longer move — a new version would have to be reintroduced in the current session.
This bill is no longer active — its legislative session has ended, so there is no live prognosis. It would have to be reintroduced in the current session to move again.
Summary
Medicare Audit Improvement Act of 2015 This bill amends title XVIII (Medicare) of the Social Security Act to require that any records or documentation of an orthotist or prosthetist who furnished an orthotic, prosthetic, or prosthetic device to an individual shall be considered part of the individual's medical record in determining whether the item is reasonable and necessary. Medicare administrative contractors (MACs) shall determine that payment may not be made to a supplier of durable medical equipment (DME) or of orthotics and prosthetics for which a claim is made because the supplier does not meet requirements for licensing or accreditation by a National Board. Recovery audit contractors (RACs) shall consider an overpayment that must be recouped any payment for DME, orthotics, or prosthetics that should not have been made because the supplier failed to meet licensing or accreditation criteria. RACs are prohibited from reviewing payments for certain DME, orthotics, or prosthetics to which prior Medicare authorization applies. The Secretary of Health and Human Services must report annually to Congress certain information on determinations by MACs that payment cannot be made, and by RACs that payment should not have been made, under Medicare for items and services. Payment is prohibited under part B (Supplementary Medical Insurance) of Medicare for orthotics and prosthetics furnished by a supplier without a supplier number. To obtain such a number a supplier must meet specified criteria. The Secretary must: (1) review annually the coverage and utilization of orthotics and prosthetics to determine whether they should be subjected to coverage and utilization review criteria, and if appropriate (2) develop and apply such criteria. Patients are not liable for payment of furnished orthotics and prosthetics which are not reasonable and necessary for the diagnosis or treatment of illness or injury or to improve the functioning of a malformed body member. Competitive acquisition programs shall not apply to off-the-shelf items and services furnished by certain orthotists or prosthetists who are either licensed or, in a state without licensing requirements, meet specified training, education, certification, or credentialing criteria. Recoupment of payments to a qualifying provider or supplier may not be made before completion of an administrative law judge appeals process. Payment under Medicare is denied to suppliers and providers unless they meet certain licensing or other qualifications.
Bill Text
We don't have the full text on file for this bill yet.
Read HR 1526 on the official United States source →Action History
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Referred to the Subcommittee on Health.
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Referred to the Subcommittee on Health.
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Referred to House Energy and Commerce
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Referred to House Ways and Means
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Referred 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.
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Introduced in House
Sponsors
- Mark Meadows · Primary
Sponsorship breakdown
Export CSV (upgrade) →1 sponsors · 0 co-sponsors · 546 not signed on
Sponsors (1)
Co-sponsors (0)
None.
Not signed on (546)
546 members have not signed on to this bill.
Show all 546 →"Not signed on" means a member has not sponsored or co-sponsored this bill — it does not imply opposition. Members flagged Voted No have a recorded No vote on this bill.
Subjects
Frequently asked questions
- What does HR 1526 do?
- Medicare Audit Improvement Act of 2015 This bill amends title XVIII (Medicare) of the Social Security Act to require that any records or documentation of an orthotist or prosthetist who furnished an orthotic, prosthetic, or prosthetic device to an individual shall be considered part of the individual's medical record in determining whether the item is reasonable and necessary. Medicare administrative contractors (MACs) shall determine that payment may not be made to a supplier of durable medical equipment (DME) or of orthotics and prosthetics for which a claim is made because the supplier does not meet requirements for licensing or accreditation by a National Board. Recovery audit contractors (RACs) shall consider an overpayment that must be recouped any payment for DME, orthotics, or prosthetics that should not have been made because the supplier failed to meet licensing or accreditation criteria. RACs are prohibited from reviewing payments for certain DME, orthotics, or prosthetics to which prior Medicare authorization applies. The Secretary of Health and Human Services must report annually to Congress certain information on determinations by MACs that payment cannot be made, and by RACs that payment should not have been made, under Medicare for items and services. Payment is prohibited under part B (Supplementary Medical Insurance) of Medicare for orthotics and prosthetics furnished by a supplier without a supplier number. To obtain such a number a supplier must meet specified criteria. The Secretary must: (1) review annually the coverage and utilization of orthotics and prosthetics to determine whether they should be subjected to coverage and utilization review criteria, and if appropriate (2) develop and apply such criteria. Patients are not liable for payment of furnished orthotics and prosthetics which are not reasonable and necessary for the diagnosis or treatment of illness or injury or to improve the functioning of a malformed body member. Competitive acquisition programs shall not apply to off-the-shelf items and services furnished by certain orthotists or prosthetists who are either licensed or, in a state without licensing requirements, meet specified training, education, certification, or credentialing criteria. Recoupment of payments to a qualifying provider or supplier may not be made before completion of an administrative law judge appeals process. Payment under Medicare is denied to suppliers and providers unless they meet certain licensing or other qualifications.
- Who sponsors HR 1526?
- HR 1526 is sponsored by Mark Meadows (R).
- What is the current status of HR 1526?
- This bill died with 114th Congress. It reached “In Committee” and never advanced before the session ended, so it can no longer move — a new version would have to be reintroduced in the current session.
- Where can I track HR 1526?
- Track HR 1526 free on One Click Politics — get push/email alerts when it moves.
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