Group Letter of Support for
Regulatory Reform Legislation (H.R.2768/H.R.3046)
Letter sent to entire U.S. House of Representatives
November 13, 2001
The Honorable Spencer Bachus
U.S. House of Representatives
442 Cannon House Office Building
Washington, DC 20515
Dear Representative Bachus:
During the past month, the Ways and Means Committee and the
Energy and Commerce Committee have worked diligently to craft
two major pieces of regulatory relief legislation, H.R. 2768,
the “Medicare Regulatory and Contracting Reform Act of
2001” (MRCRA), introduced by Representatives Johnson
and Stark, and H.R. 3046, the “Medicare Regulatory, Appeals,
Contracting, and Education Reform Act” (RACER), introduced
by Representatives Toomey and Berkley. These bills would address
many of the regulatory burdens impacting the country’s
patients, physicians and providers. In particular, they would
provide especially helpful due process rights to physicians
and providers faced with government audits, and create very
important education requirements, the effects of which cannot
be overstated. As the legislation moves forward to the House
floor, the undersigned groups express our thanks for these
reforms and urge the House to retain the following provisions
in the final bill:
Extrapolation – Both MRCRA and RACER have essential
extrapolation language which would limit extrapolation to
situations where there is either a sustained or high payment
error rate or documented education efforts have failed to
correct the error. Both bills also contain language which
would require contractors to notify physicians at least 45
days prior to sending a consent settlement letter. However,
RACER contains additional language specifying the contents
of the required notice. This detailed notification is essential
to physicians who wish to correct their claims or seek to
discuss with the contractor whether their claims are coded
or documented correctly. It is our hope that this language
will be retained.
Written Advice from Contractors – We strongly believe
that legislation considered by the House should require contractors
to issue specific written guidance that physicians can rely
upon if later audited. While both MRCRA and RACER are substantial
improvements over current contractor practices, we urge the
Committees to ensure that physicians, hospitals and other
providers are able to obtain specific written answers to their
questions regarding often complex and confusing Medicare requirements.
Emergency Medical Treatment and Active Labor Act (EMTALA)
– We urge the incorporation of the RACER provisions on
EMTALA. RACER would apply a “prudent layperson”
standard similar to the standard set forth in MRCRA and would
also establish an EMTALA task force, require peer review organization
review prior to provider terminations, and require notification
of physicians and providers when an EMTALA investigation has
been closed. These are essential reforms which would help
address the overexpansive nature of EMTALA.
Physician Review of Physician Determinations – Finally,
we urge the retention of RACER language that would ensure
that Medicare Qualified Independent Contractors would be physicians
to the extent that they are reviewing physician items and
services provided to patients.
With bipartisan and multi-committee support for achieving
regulatory reform, we strongly urge passage of regulatory
reform legislation, with the above elements, this year.
Sincerely,
American Academy of Child and Adolescent Psychiatry
American Academy of Dermatology Association
American Academy of Facial, Plastic and Reconstructive Surgery
American Academy of Family Physicians
American Academy of Neurology
American Academy of Ophthalmology
American Academy of Otolaryngic Allergy
American Academy of Otolaryngology – Head and Neck Surgery
American Academy of Physical Medicine and Rehabilitation
American Academy of Sleep Medicine
American Association for Thoracic Surgery
American Association for Vascular Surgery
American Association of Clinical Endocrinologists
American Association of Neurological Surgeons
American Association of Orthopaedic Surgeons
American College of Cardiology
American College of Chest Physicians
American College of Emergency Physicians
American College of Nuclear Physicians
American College of Obstetricians and Gynecologists
American College of Osteopathic Family Physicians
American College of Osteopathic Surgeons
American College of Physicians-American Society of Internal
Medicine
American College of Radiology
American College of Rheumatology
American College of Surgeons
American Gastroenterological Association
American Geriatrics Society
American Medical Association
American Medical Directors Association
American Medical Group Association
American Osteopathic Association
American Psychiatric Association
American Society for Gastrointestinal Endoscopy
American Society for Therapeutic Radiology and Oncology
American Society of Anesthesiologists
American Society of Cataract and Refractive Surgery
American Society of Clinical Oncology
American Society of Clinical Pathologists
American Society of General Surgeons
American Society of Hematology
American Society of Plastic Surgeons
American Thoracic Society
American Urogynecologic Society
American Urological Association
Association of American Medical Colleges
College of American Pathologists
Congress of Neurological Surgeons
Infectious Diseases Society of America
Joint Council of Allergy, Asthma and Immunology
Medical Group Management Association
National Association for Medical Direction of Respiratory
Care
North American Spine Society
Renal Physicians Association
Society of Cardiovascular and Interventional Radiology
Society of Critical Care Medicine
Society of General Internal Medicine
Society of Gynecologic Oncologists
Society of Nuclear Medicine
Society of Thoracic Surgeons
Society for Vascular Surgery
The Endocrine Society
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