Statements and Speeches

WASHINGTON – Today, Sen. Tom Carper (D-Del.), a member of the Senate Finance Committee, released the following statement regarding the committee’s markup on “Audit & Appeal Fairness, Integrity, and Reforms in Medicare Act of 2015.” 

“I thank Chairman Hatch and Ranking Member Wyden for their hard work and dedication in drafting legislation to improve the Medicare audits and appeals process.  I believe the chairman and ranking member have put together a strong bill that has found common ground on what is, at times, a contentious issue.

“Without a doubt, we must ensure that Medicare continues to provide critical care to our nation’s seniors and the disabled, but at the same time, we must find ways to contain the growth of health care costs.  The latest estimates show that almost $46 billion of Medicare fee-for-service expenditures were lost through improper payments during the last fiscal year.  Unfortunately, that level has been increasing during the past few years, which underscores the need for smart and effective auditing.

“I believe the bill before us today helps ensure the auditing process is effective, but also that Medicare audits are conducted fairly, and without undue burdens on health care providers.

“In this spirit, I would like to offer a simple, but helpful, amendment that would improve the transparency of Medicare audits and oversight.

“At times, heath care providers face challenges when their claims are under audit.  Claims under review by administrative law judges have a single web-based system for providers to determine the status of a claim.  However, at other levels in the audit process, each contractor maintains a separate system. There is no centralized way for a provider to determine the status of a claim under audit, or even which audit contractor is reviewing the claim.

“To improve this process, my amendment would create an Internet-based system that providers can use to find information on the status of claims under review.  Since the Centers for Medicare and Medicaid Services already has an established operational electronic system for internally tracking claims under audit, creating a modified system for providers and others to access this information would not prove difficult.

“I hope my colleagues will support my amendment and the overall legislation.”