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Williams calls for Medicare reforms

January 8, 2014

Today, Congressman Roger Williams (TX-25) called for reforms in Medicare reimbursement procedures after a Texas news report revealed a local hospital was unable to pay dozens of its employees over Christmas.

In September 2013, Williams introduced H.R. 3168, the Medicare Established Provider Act, to alleviate the claims reimbursement backlog and speed up reimbursements to dependable providers. The bill would amend title XVII of the Social Security Act to provide a Medicare established for trusted provider system.

Medicare contractors currently process over 1 billion claims per year. Under this system, providers of services and suppliers representing a low risk for submitting fraudulent Medicare claims are provided certain claim review protections. In short, all providers would apply for participation in this system, and, if accepted, would take a web based course to establish a knowledge base for rules and claims submission. With the ability to establish a fast track for processing claims and limit timeframes for the reconsideration process, established providers will be able to act more efficiently.

Williams' floor speech can be viewed here. Remarks follow.

"Mr. Speaker, last week a news report revealed that a hospital in Houston, TX – my home state – was unable to pay dozens of its employees during the holidays due to a new Medicare payment contractor. Nearly 150 employees, ranging from doctors to nurses to administrators, missed several scheduled paychecks because the hospital's Medicare payment facilitator is taking too long to process Medicare claims for reimbursement.

"Unfortunately, this is a growing problem plaguing medical facilities and hardworking employees across the country. That's why my bill, the Medicare Established Provider Act, should come to the House floor for a vote quickly. H.R. 3168 will help alleviate the reimbursement backlog by creating a trusted provider system. Like this hospital in Texas, there are many established Medicare providers with a proven history of timely, valid claims. They should be rewarded with prompt reimbursements rather than put in limbo for months or years at a time.

"Allowing this bill to pass would allow companies and small business to expand and would streamline the process for these trusted providers. As the backlog of claims continues to rise, the livelihood of employees and businesses should not be put at risk. I hope this bill will get serious consideration."

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