US House Ways and Means Chair Questions RAC Audit Settlement by HHS

Tuesday, September 16, 2014, the Chairman of the US House Ways and Means Subcommittee on Health Kevin Brady (R-TX) sent a strongly worded letter to Health and Human Services (HHS) Secretary Sylvia Burwell on the RAC audits settlement HHS announced just before the Labor Day weekend.

In his letter, Chairman Brady questions the statutory authority for HHS to use a settlement process to address the Medicare appeals backlog and requests an “explicit description of the HHS statutory authority to settle claims determined to be not medically necessary.”  In addition, the Chairman raises concerns over the HHS process, including the “all or nothing” approach, the empirical analysis to justify the 68 percent settlement rate, and how the settlement process will affect beneficiary cost-sharing requirements. Chairman Brady concludes by urging HHS to retract the settlement process posted by the Centers for Medicare & Medicaid Services (CMS) on its website on August 29, 2014 and work with the Committee on an alternative process.  More information on the CMS settlement process.


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