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Tag: Bad Debts

H.R. 3630 Conference Bill Health Offsets

H.R. 3630 Conference Bill Health Offsets

From: H.R 3630 Conference Report – 2/13/12

The conference bill reveals the following Medicare cuts agreed to be made:

  • Sec. 3201 – Reduction of Bad Debts treated as an allowable cost – Hospital/SNF allowable bad debts will  be reduced to 35% (currently 70%) amounts beginning in FFY 2013. (See Pages 92-93)
  • Sec. 3201 – Reduction of Bad Debts treated as an allowable cost – CAH allowable bad debts will be reduced to 88% (currently 100%) in FFY 13, 76% in FFY 14 and 65% in subsequent FFYs. (See Pages 94-95)
  • Sec. 3202 – Rebase Medicare Clinical Laboratory Payment Rates – Fee schedule will be reduced by 2% starting in FFY 2013 (See Page 96)
  • Sec. 3203 – Rebasing State DSH Allotments for FY 2021 – Conference bill does not provide details of the specific impact (See Page 97).
  • Sec. 3205 – Prevention and Public Health Fund – Made changes to the funds available from 2012 – 2022 (See Page 98-99).  $5 Billion diverted according to above article.
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Medicare Bad Debt Decisions – 1987 Moratorium

George Washington University Hospital – FYE 12/31/99

CMS Admin Decision PRRB 2011-D31

Universal Health Svcs, Inc. – FY 2004 & 2005

CMS Admin Decision: PRRB 2011-D30

Both of the above PRRB decisions were overturned by the CMS Administrator. The common issue involved Medicare bad Debt claims that were denied by the FI because the accounts continued to reside at collection agencies. The issue involved the Bad Debt Moratorium that prevents CMS and te FIs from changing bad debt policy in effect prior to 1987.

The PRRB ruled in favor of the Providers stating:

“The Intermediary improperly disallowed the Provider’s claimed bad debts solely on the ground that accounts related to such bad debts still remained at an outside collection agency.”

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