AAFP Pushes Back on CMS Physician Overpayment Proposal

The American Academy of Family Physicians is calling on CMS to change a proposed rule on reporting and returning physician overpayments. The final rule should clearly distinguish the differences between occasional overpayments and actual fraudulent activities by Medicare providers and suppliers, according to a recent letter written by the AAFP board chairman.

"The AAFP is troubled that this proposal essentially creates an unfunded requirement that forces medical practices to implement self-audits and internal compliance plans," wrote AAFP Board Chair Roland Goertz, MD. "Though often recommended business practices, they are time-consuming, expensive and never before required by Medicare. Further troubling is that this considerable burden is not even addressed in the regulatory impact section."

Dr. Goertz added that the AAFP opposes CMS' proposal to use a 10-year look-back period for overpayment. The Health Insurance Portability and Accountability Act of 1996 requires physicians to maintain billing records for just six years, he wrote.

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