Medicare Established Provider Act of 2015
Bill journey · stage 2 of 5
Under committee review
What it doesSummary introduced in house (Nov 18, 2015)
Medicare Established Provider Act of 2015
This bill amends title XVIII (Medicare) of the Social Security Act to direct the Department of Health and Human Services (HHS) to develop a system for designating providers that represent a low risk of submitting fraudulent Medicare claims as "established providers" for purposes of applying for special treatment in the claim review process.
To qualify as an established provider, a provider must demonstrate that, within a specified timeframe: (1) at least 90% of Medicare claims submitted by the provider were determined to be eligible for full or partial payment, and (2) the provider appealed at least 90% of all Medicare claims that were not initially determined to be eligible for payment.
HHS may withhold payment for a Medicare claim made by an established provider only if a final determination has been made that the claim is ineligible for payment. If such a final determination is made, the provider shall repay such payment electronically and within a specified timeframe.
What just happenedNov 20, 2015
Referred to the Subcommittee on Health.
Who’s behind it
- Introduced in HouseNov 18, 2015
- Nov 20, 2015Committee
Referred to the Subcommittee on Health.
Health Subcommittee - Nov 18, 2015Committee
Referred to the Subcommittee on Health.
Health Subcommittee - Nov 18, 2015IntroReferralH11100
Referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Energy and Commerce Committee - Nov 18, 2015IntroReferralH11100-A
Referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
- Nov 18, 2015IntroReferralH11100
Referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Ways and Means Committee - Nov 18, 2015IntroReferralIntro-H
Introduced in House
- Nov 18, 2015IntroReferral1000
Introduced in House