Medicare Audit Improvement Act of 2015
Latest action. Referred to the subcommitteeA smaller panel inside a standing committee with jurisdiction over a slice of its subject matter. Most hearings and the first markup usually happen here.Read the full definition (opens a new tab) on Health.
Medicare Audit Improvement Act of 2015
This bill amends title XVIII (Medicare) of the Social Security Act (SSAct) with respect to the practices of recovery audit contractors (RACs) under the Medicare program fin identifying underpayments and overpayments and recouping overpayments.
Incentive payments to a RAC for recovery activities are prohibited for FY2015 and subsequent fiscal years.
Payments for recovery activities shall be reduced, according to a sliding scale established by the Secretary of Health and Human Services, to any RAC with a complex audit denial rate at the end of a fiscal year, determined pursuant to a specified formula, that is .1% or greater.
The one-year timely filing limit for certain rebilled SSAct title XVIII part B (Supplementary Medical Insurance) claims is eliminated, extending the deadline for the rebill to 180 days after final denial of the claim.
A determination of whether inpatient hospital services or inpatient critical access hospital services furnished to an individual are reasonable and necessary shall now be based solely on information available to the admitting physician at the time of the inpatient admission of the individual for such services, as documented in the medical record.
Written by analysts at the Congressional Research Service and published on Congress.gov, not by Civibrief. Summarized at the "Introduced in House" stage on April 30, 2015. It describes the bill, it is not the legal text.
Where is it in the process, and what happens next?
4 steps remain before this bill could become law.
The record's latest action, on May 18, 2015: Referred to the Subcommittee on Health.
- Clearing the committees it was referred to, and being scheduled for a floor vote
- Passage by the House
- Passage by the Senate
- The President's signature. If the President vetoes it, two-thirds of both chambers must vote to override.
How likely is it to become law?
Civibrief does not forecast outcomes and this page has no opinion about this one. What the record supports is a base rate, which is a fact about the whole pile, not a prediction about this measure.
In the 114th Congress (2015-16), 329 of the 10,233 bills and joint resolutions introduced became law, about 3.2 percent. That count covers every measure at every stage, including the many that never left committee.
This one is not there yet: 4 steps are still outstanding, listed above.
Has anyone actually voted on it?
No. No roll call in this Congress cites this measure. That is the ordinary outcome: most measures never reach a recorded floor vote, and a committee ends most of them simply by not acting.
A vote is not the only thing that happens to a measure. Hearings, markups, and referrals are all recorded actions, and none of them is a vote of the full chamber.
Who is behind it?
SAM GRAVES (R-MO) introduced it on April 30, 2015, and 87 members have since signed on as cosponsors.
They come from both major parties: 36 Democrats, 51 Republicans.
Cosponsoring is a formal signature on the text. It is not a commitment to vote for the measure, it does not bind anyone's party, and a long list of cosponsors is a measure of attention rather than of prospects.
How long has it been in play?
It was introduced on April 30, 2015, 4151 days ago. The most recent recorded action was 4133 days ago, on May 18, 2015.
Measures do not carry over. Anything the 114th Congress has not finished by January 3, 2017 dies when the term ends, and has to be introduced again from the start in the next Congress.
Every answer above is assembled from this measure's own record on Congress.gov and from published counts of what Congress has passed before. Civibrief does not predict outcomes and takes no position on any measure.
Vote history
- HouseIn committee, no floor vote yet
- SenateAwaits House passage
- PresidentAwaits both chambers