Extrapolation in Senate's hands

Monday, December 31, 2001

WASHINGTON - Now that the House has passed its version of regulatory and contracting relief, the Senate Finance Committee is looking at the issue under the guise of the Medicare Appeals, Regulatory and Contracting Improvement Act of 2001 (S. 1738).

Like its counterpart in the House, the Senate version would allow providers to delay providing refunds of disputed overpayments until after the first level of appeal. Unlike the House bill, the Senate bill does not address a carrier's ability to extrapolate overpayments across a "universe of beneficiaries," according to the Washington-based Power Mobility Coalition (PMC).

"Extrapolation is really onerous," said PMC counsel Steve Azia. "Let's say you're a small provider and get 30 claims reviewed. If they look at 10 and don't like them, you could have one-third of your payments for the last three years to pay back. You can't survive that."

The PMC wants the Senate to amend its bill to prohibit the use of extrapolation as a matter of standard policy. The Senate is expected to vote on the bill in April or May. HME