PRACTICE RESOURCES > Regulation/AUA Positions, Letters, and Talking Points > Congress Regarding MERFA Bill

Congress Regarding MERFA Bill

Statement of Irwin N. Frank, MD, FACs, President of the American Urological Association on the Medicare Education and Regulatory Fairness Act of 2001

On behalf of the American Urological Association (AUA), representing 9,200 American urologists, I am writing in support of a very important piece of legislation being introduced today — the Medicare Education and Regulatory Fairness Act of 2001. This bill would provide needed outreach and education to physicians and health care providers and would guarantee physicians certain due process rights, including an equitable right of appeal.

Under current law, physicians must comply with numerous federal mandates to complete forms such as advance beneficiary notices and medical necessity certifications, and to file enrollment forms in order to comply with coding documentation guidelines. The AUA agrees with President George W. Bush and HHS Secretary Tommy Thompson that Medicare's bureaucracy and regulatory burdens are driving health care professionals from the profession. There is increasing evidence that physicians are not accepting new Medicare patients for fear that failure to comply with Medicare's complex rules can result in punitive actions that will potentially undermine the physician's practice.

An example of such punitive action occurred in Alabama in 1999. The Alabama Medicare Carrier experienced problems changing the payment for a prostate cancer drug in their computer. As a result, the Carrier overpaid physicians for the drug. When the payment error was discovered, letters that read like audits demanded repayment for "Medicare fraud" violations, within 30 days. The letters went on to suggest that urologists were performing medically unnecessary services. Even though the overpayments that occurred were caused solely by the failure of the Carrier to program its computers correctly, the letters took on a heavy handed, accusatory tone. Since then, the repayment time frame has been extended to 60 days, this time frame still places an unnecessary burden on physicians. This example highlights the importance of a three-year payment arrangement for Carrier overpayment, a provision that is included in the bill that will be introduced today.

The AUA strongly supports the Medicare Education and Regulatory Fairness Act of 2001, as it will guarantee physicians equitable rights of appeal and better target current Medicare education dollars to provide outreach and education to physicians and other health care providers. Moreover, this bill will ensure that the costs of regulatory burdens are reflected in the sustainable growth rate formula used in updating physician payments.

On behalf of the AUA and the patients we treat, I thank all of the congressional sponsors for their leadership, and strongly urge Congress to enact this outstanding legislation this year. We look forward to working with you in order to make this happen.


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