From the Office of Senator Kerry

Wednesday, March 7, 2001

Washington, DC – U.S. Senators John F. Kerry (D-MA) and Frank Murkowski (R-AK) joined Representatives Shelley Berkley and Pat Toomey in a press conference today to unveil their Medicare reform legislation to streamline and reform the Medicare system which is unfairly penalizing law abiding healthcare providers including home health care agencies, physicians, hospitals, and nursing homes.

"There is no doubt that we need to eliminate waste, fraud and abuse in the Medicare system, but in our zeal to eliminate these problems, we are now unfairly targeting law-abiding healthcare providers. No one will deny that the Health Care Financing Administration has a difficult job but it is a huge problem when the regulations they establish, and the manner in which they enforce them, stops our parents and grandparents from receiving the very health care they need and deserve. This legislation represents a reasonable, commonsense approach to streamlining recent Medicare requirements which unfairly punish law abiding health providers. Without demagoguery, without attempting to dismantle the important work that is done at the Health Care Financing Administration, this bill provides common sense reform."

"The case of the Southeastern MA Visiting Nurses Association is just one example of the unintended consequences of this legislation that we are seeing all across the country. After losing thousands of dollars, without finding any evidence of wrongdoing, this agency was audited three times in one year and was almost bankrupted by an inappropriate penalty. The harassment endured by law abiding providers like the Southeastern MA VNA is unfair and unnecessary – and this legislation is an important step towards necessary reform."

The Murkowski-Kerry Medicare Education and Regulatory Fairness Act (MERFA) has three major objectives. First, the bill requires the Health Care Financing Administration (HCFA) to provide education and guidance to Medicare providers who are attempting to properly complete and submit patient claims for reimbursement. Second, the bill limits HCFA's use of sampling audits in targeting model health care providers and prevents HCFA from utilizing the extrapolation method to assess the penalties these providers must pay. Third, the bill establishes due process rights which would allow for a stay of alleged overpayments during the period that physicians and providers have pending appeals.