Part B Insider (Multispecialty) Coding Alert

Published on Wed May 07, 2003 PDF

Physicians who make a mistake while filling out a Medicare claim will pay a price under President Bush's new budget plan.

In an effort to raise revenue, the Bush administration has put forth the idea of imposing or raising user fees - including fees for health care providers who submit erroneous Medicare claims and file claims appeals.

The notice appears on Page 26 of the Department of Health and Human Services' spending plan. "The budget proposes new discretionary user fees paid by providers who file a Medicare claims appeal or submit duplicate or unprocessable claims," it states.

A spokesperson for the Centers for Medicare & Medicaid Services tells Eli that the plan imposes a new $250 fee on unprocessable Medicare claims and a new $50 fee on Medicare appeals.

Keith Ashdown, spokesperson for the Washington-based Taxpayers for Common Sense, says user fees represent "a new layer" in this year's budget. The General Accounting Office has identified Medicare claims errors as a recurring problem, he points out.

"It looks like the budget hawks in the administration have said this is a way we can make sure this doesn't happen," Ashdown says.

The Medicare fees are among a host of new or increased user fees put forth in Bush's spending plan. They include fee hikes for veterans' health care services and processing of visa applications.

The Bush administration expects to raise a total of $176.3 billion next year through user fees, about $6 billion more than the $170.4 billion now raised, the Associated Press reports. Of that increase, about $2 billion reflects White House proposals for higher fees or charges that don't currently exist. The other $4 billion represents additional revenues expected from existing user charges.

The question now is whether Congress will embrace the user fees. Ashdown gives their chance of passing a "maybe" rating. "People are looking at user fee proposals not as to their general merits but as smoke-and-mirror revenue changes to make the budget look better than it is," he observes.