About | HeinOnline Law Journal Library | HeinOnline Law Journal Library | HeinOnline
LOG IN
LOG IN

HRD-83-38 1 (1983-03-04)

handle is hein.gao/gaobabmvs0001 and id is 1 raw text is: UNITED STATES GENERAL ACCOUNTING OFFICE WASHINGTON, D.C. 20548 HUMAN R COURCX3 DIVISION B-210513 MARCH 4,1983 Mr. Thomas R. Donnelly ,,ore..,IIIoIll l I ll Ill Ill Acting Secretary of Health and Human Services 120712 Dear Mr. Donnelly: Subject: Savings Possible by Modif~ing Medizare's Waiver of Liability Rules (GAO/HRD-83-38) As part of its 1983 budget-cutting proposals, the admin- istration sought, but did not obtain, legislation to modify Medicare's waiver of liability provision with respect to pay- ments to hospitals, skilled nursing facilities, and home health agencies.1 According to the President's proposals, this change would have resulted in a net savings of $10 million in fiscal year 1983. We believe that such legislation is not necessary. Savings could be realized by changing the waiver of liability rules. THE WAIVER OF LIABILITY PROVISION Medicare's waiver of liability provision, section 1879 of the Social Security Act, protects beneficiaries from having to pay for services they receive that Medicare will not pay for because it determined the services were not medically reason- able or necessary or were custodial in nature. The provision authorizes HHS to indemnify beneficiaries against the costs associated with the claims denied for payment2 as long as IBudget material for fiscal year 1984 states that HHS will again request such legislation. 21f the provider bills the beneficiary and he or she pays for the denied services, Medicare reimburses him or her at Medi- care's normal payment rate for the service in question, less any applicable deductible and coinsurance. The amount reim- bursed to the beneficiary is treated as an overpayment to the provider to be withheld from future payments. In fiscal year 1981, Medicare paid 74 indemnification requests totaling $46,577. (106220) ., 11 ,%,

What Is HeinOnline?

HeinOnline is a subscription-based resource containing thousands of academic and legal journals from inception; complete coverage of government documents such as U.S. Statutes at Large, U.S. Code, Federal Register, Code of Federal Regulations, U.S. Reports, and much more. Documents are image-based, fully searchable PDFs with the authority of print combined with the accessibility of a user-friendly and powerful database. For more information, request a quote or trial for your organization below.



Contact us for annual subscription options:

Contact Us

Already a HeinOnline Subscriber?

Log In

profiles profiles most