Fair Medical Audits Act of 2015
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HR 2568 — Fair Medical Audits 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This bill is no longer active — its legislative session has ended, so there is no live prognosis.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
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.
Bill Text
We don't have the full text on file for this bill yet.
Read HR 2568 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
- George Holding · 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 2568 do?
- 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.
- Who sponsors HR 2568?
- HR 2568 is sponsored by George Holding (R).
- What is the current status of HR 2568?
- 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 2568?
- Track HR 2568 free on One Click Politics — get push/email alerts when it moves.
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