Summary: H.R.5200 — 106th Congress (1999-2000)All Information (Except Text)

There is one summary for H.R.5200. Bill summaries are authored by CRS.

Shown Here:
Introduced in House (09/18/2000)

Medicare Billing and Education Act of 2000 - Title I: Regulatory Reform - Amends title XVIII (Medicare) of the Social Security Act (SSA) with regard to: (1) the prospective-only, non-retroactive application of regulations of the Secretary of Health and Human Services that establish or change a substantive legal standard governing the scope of benefits, the payment for services, or the eligibility of individuals, entities, or organizations to furnish or to receive Medicare services or benefits; and (2) allowance of civil actions against the Secretary challenging the constitutionality of regulations or policies.

Prohibits the Secretary from recovering past Medicare overpayments by offsetting future payments to a health care provider, or while a provider is appealing a determination that an overpayment has been made or the amount of such an overpayment.

Title II: Appeals Process Reforms - Revises requirements for the post-payment audit process, particularly the recoupment of overpayments.

Requires the Secretary to permit any health care provider to appeal any determination of the Secretary under Medicare on behalf of a deceased beneficiary where no substitute party is available.

Title III: Education Components - Amends SSA title XVIII to provide for education programs for physicians, providers of services, and suppliers.

Requires fiscal intermediaries and carriers to do their utmost to provide health care providers with one, straight, and correct answer regarding Medicare billing and cost reporting questions, as well as their true first and last names.

Requires the Secretary to establish a process for providers to request assistance in writing (advisory opinions) from fiscal intermediaries or carriers in addressing questionable Medicare coverage, billing, documentation, coding and cost reporting procedures.

Title IV: Sustainable Growth Rate Reforms - Requires the inclusion of regulatory costs in the estimate of the sustainable growth rate for all physicians' services for a fiscal year.

Title V: Studies and Reports - Requires the Comptroller General to: (1) audit and report to Congress on Health Care Financing Administration compliance with statutes administered by it and with administrative procedure and other requirements under Federal civil service law; and (2) study and report to Congress on whether policies or enforcement efforts against health care providers have reduced access to care for Medicare beneficiaries.