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DOCUMENT RESUME
05993 - ( 81526572 1 (Restricted)
[Information on Assignment Rates under Medicare ]. HRD-78-111;
B-164031(4). May 31, 1978. 2 pp. # enclosure (15 pp.).
Report to Rep. John 3. doss, Chairman, House Committee on
Interstate and Foreign Commerce: Oversight and Investigations
Subcommittee; Rep. Anthony Moffett; by Elmer S. Staats,
Comptroller Gcneral.
Issue Area: Health Programs: Reimbursement Policies and
utilization Controls (1208).
Contact: Human Resources Div.
Budget Function: Health: General Health Financing assistance
(555).
Organization Concerned: Department of Health, Education, and
Velfare.
Congressional Relevance: House Committee on Interstate and
Foreign Coserce: oversight and Investigations Subcommittee.
Rep. John E. oss; Rep. Anthony Moffett.
Authority: Social Security Amendments of 1972 (P.L. 92-603; 42
U.S.C. 1395b). Hedicare-Medicaid Anti-Fraud and Abuse
Amendments (P.L. 95-142; 91 Stat. 1202). Social Security
Act. S. 1470 (95th Cong.). H.R. 7079 (95th Cong.). U.R. 9916
(95th Cong.). H.R. 12244 (95th Cong.).
Under medicare, physicians have an option on each claim
to accept assignment for charges to medicare patients. By
accepting assignment, the physician agrees to accept as payment
in full that amount which medicare determines to be reasonable.
In response to congressional concern over the lou medicare part
B assignment rate in Connecticut, the following were reviewed:
historical assignment rates in Connecticut and other New England
States, studies concerning reasons why physicians do or do not
accept assignment, a study of the potential effects of mandatory
assignment, the effects of mandatory assignment under medicaid,
pending legislative proposals, and other legislative options for
increasing assignment rates. Nationwide, the general trend has
been a decline in assignment rates. Two studies showed that
physicians, in deciding whether to accept assignment, respond to
economic incentives or disincentives. Factors affecting
Connecticut's assignment rate included: the per capita income of
the area, uncertainty as to what medicare's reascnable charges
would be, and complicated claims mechanisms. Reasons cited for
low participation rates in medicaid involved: lower
reimbursement rates, lengthy claims processing time, and
excessive paperwork. Three options which might have some
positive effect on assignment rates are pending in the Congress.
Vhile it is difficult to determine the specific effect
implementation of any option or combination of options would
have, the logical step would be to carry out demcnstration
projects to test the results of various studies. (RRS)](ViewImageLocal?handle=hein.gao/gaobaaxht0001&div=1&collection=&method=preview&ext=.png&size=3)