WASHINGTON, D.C. – U.S. Senator Jerry Moran (R-Kan.), Ranking Member on the Senate Appropriations Subcommittee on Labor, Health and Human Services, Education, and Related Agencies, met with United States Department of Health and Human Services (HHS) Secretary Sylvia Mathews Burwell Wednesday to discuss health care topics important to Kansans.
“As I travel across the state visiting with patients, hospital administrators, doctors and other health care providers, almost every discussion involves concerns with the burdens Washington policies place on our providers as they work to care for Kansans,” Sen. Moran said. “Kansans are strongly opposed to the Obama Administration’s proposals to cut reimbursements to Critical Access Hospitals and eliminate hospitals from this essential rural health program. I explained to Secretary Burwell how the Administration’s policies would jeopardize the survival of many rural hospitals and endanger access to health care in our own communities. I appreciate the Secretary’s willingness to meet with me, and I look forward to a renewed dialogue with her and her team on a range of health care topics important to our state.”
In addition to discussing the importance of hospitals to the rural health care delivery system, Sec. Burwell and Sen. Moran visited about the urgent need to improve the Medicare’s Recovery Audit Contractor program, the unprecedented influx of unaccompanied children from Central America arriving at the United States border, and the valuable role that pharmacists play in delivering health care in their communities.
During Sec. Burwell’s time as director of the Office of Management and Budget, the Administration proposed cuts to Critical Access Hospitals (CAHs) and to eliminate hospitals from the CAH program based on an arbitrary geographic mileage criteria. CAHs are small, rural hospitals that receive enhanced Medicare reimbursements to provide care to an increasingly aging population across wide rural areas. Kansas has 83 of these hospitals, more than any other state.
Sen. Moran has heard from many Kansas hospitals and health care providers who are frustrated with the Medicare Recovery Audit Contractor (RAC) program. They have been forced to divert significant resources away from caring for patients to appeal incorrect audit decisions that are ultimately overturned. He has raised several concerns about this program in letters to HHS, at Appropriations Committee hearings and through language included in the FY2014 Omnibus Appropriations bill and FY2015 Senate Labor-Health-Education Appropriations bill. We need to achieve a balance of safeguarding Medicare finances while avoiding costly burdens on hospitals and health care providers that are affecting their ability to care for patients.
The RAC program focuses on post-payment reviews of Medicare claims from health care providers to prevent improper payments, but unfortunately flaws in the program are yielding incorrect audit results. This broken program is unreasonably burdening providers, and has created a two-year appeals backlog at HHS’ Office of Medicare Hearings and Appeals (OMHA). According to the HHS Inspector General, 56 percent of RAC appeals are reversed at OMHA, while several Kansas hospitals have appeal-win rates around 95 percent. Earlier this month, HHS provided an update about its working group focused on addressing the Medicare appeals backlog at OMHA. The objective of this working group is to adopt proposals at HHS to address problems with the RAC program and reduce the appeals backlog.