News Headlines Article

Legislators decry broken Medicare payment appeals process
Modern Healthcare

Legislators from both sides of the aisle expressed concern during a congressional hearing Tuesday that vigorous federal investigations of potential Medicare fraud could result in providers that have done nothing wrong being unfairly punished.

While legislators stressed that they want transgressors punished, they worried that the system for appealing Medicare payment decisions is so broken that it offers little protection for providers that have been wrongly denied reimbursement for treatment they delivered. The hearing showcased once again why it’s easy for politicians to talk about cracking down on Medicare fraud and abuse but devilishly hard to carry it out.