Sen. Charles Grassley (R-Iowa) has introduced legislation that would give the federal government more time to pay Medicare providers when fraud, waste, or abuse is suspected.
Federal law requires that Medicare send payment within a short time frame irrespective of the risk of fraud, waste, or abuse. “Because of this prompt payment rule, the government puts itself in a position of having to pay and chase Medicare fraud, instead of working to prevent it in the first place. That doesn’t make any sense,” Sen. Grassley said in a statement issued by his office, “and it’s no way to manage Medicare’s resources.”
The bill, known as the Fighting Medicare Payment Fraud Act of 2009, would give the Secretary of Health and Human Services authority to extend the time period in which payments must be made under the prompt payment rule if the Secretary determines there is a likelihood of fraud, waste, or abuse. With this additional time, the Secretary would be required to conduct more detailed reviews of the claims in question to make sure they should be paid.
The proposed law would authorize the extension of the time period that claims must be paid to up to one year for categories of suppliers or providers in a particular geographic area or individual providers when there is a likelihood of fraud, waste, or abuse. For individual providers or suppliers, the Secretary would be required to take whatever time is necessary to engage in more in-depth reviews to determine that the claims should be paid.
The Grassley bill would also require the Office of Inspector General to recommend, on at least an annual basis, categories of providers or suppliers where additional scrutiny is needed before payments are made under the prompt payment rule. To make sure there is action on these recommendations, the Secretary would be required to provide a response to the Inspector General on these recommendations.
