Journal of Gerontological Nursing

Release of Medicare Contingency Funds Urged

Abstract

Several health-care groups, including the National Association of Medical Equipment Suppliers, the American Medical Association, the American Hospital Association, and the Health Insurance Association of America, are urging the immediate release of $101.3 million in contingency funds to supplement Medicare Part B program operating funds for fiscal year 1991.

The immediate release of these funds by the Office of Management and Budget (OMB) is seen by the Health Care Financing Administration as the only way to avert extensive paperwork backlogs and long delays in claims payments for Medicare beneficiaries and healthcare providers in 1991 and beyond.

In a recent letter to several large insurance groups, Barbara Gagel, Director of the Medicare Bureau of Program Operations, warned that Medicare payments to beneficiaries and health-care providers will be substantially delayed this year unless the contingency funds are released by OMB.

Projected payment delays, according to Gagel, could be as long as 60 to 70 days for Part B payments. She cited two factors that have substantially increased carrier workloads, "a claims volume that is 8.1% higher than anticipated in the (fiscal year 1991) budget request; and the implementation and operation of more than 40 Omnibus Reconciliation Act (OBRA 90) changes in the Medicare program."

In a meeting with representatives of several health-care groups, representatives of Blue Cross/Blue Shield cautioned that if the contingency funds are not released, Medicare could end up paying more in late interest payments on delayed claims than the $101.3 million they are seeking in contingency funds. Medicare is obliged by law to pay interest on payments delayed beyond a 24day limit.

For more information, contact Kathleen Riley, National Association of Medical Equipment Suppliers, 625 Slaters Lane, Suite 200, Alexandria, VA 22314; 703-836-6263.…

Several health-care groups, including the National Association of Medical Equipment Suppliers, the American Medical Association, the American Hospital Association, and the Health Insurance Association of America, are urging the immediate release of $101.3 million in contingency funds to supplement Medicare Part B program operating funds for fiscal year 1991.

The immediate release of these funds by the Office of Management and Budget (OMB) is seen by the Health Care Financing Administration as the only way to avert extensive paperwork backlogs and long delays in claims payments for Medicare beneficiaries and healthcare providers in 1991 and beyond.

In a recent letter to several large insurance groups, Barbara Gagel, Director of the Medicare Bureau of Program Operations, warned that Medicare payments to beneficiaries and health-care providers will be substantially delayed this year unless the contingency funds are released by OMB.

Projected payment delays, according to Gagel, could be as long as 60 to 70 days for Part B payments. She cited two factors that have substantially increased carrier workloads, "a claims volume that is 8.1% higher than anticipated in the (fiscal year 1991) budget request; and the implementation and operation of more than 40 Omnibus Reconciliation Act (OBRA 90) changes in the Medicare program."

In a meeting with representatives of several health-care groups, representatives of Blue Cross/Blue Shield cautioned that if the contingency funds are not released, Medicare could end up paying more in late interest payments on delayed claims than the $101.3 million they are seeking in contingency funds. Medicare is obliged by law to pay interest on payments delayed beyond a 24day limit.

For more information, contact Kathleen Riley, National Association of Medical Equipment Suppliers, 625 Slaters Lane, Suite 200, Alexandria, VA 22314; 703-836-6263.

10.3928/0098-9134-19910401-13

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