According to Kimberly Brandt, Chief Oversight Counsel for the Senate Finance Committee’s majority staff, the Senate Finance Committee could reintroduce the Audit & Appeals Fairness, Integrity, and Reforms in Medicare Act of 2015 (AFIRM Act), which is intended to address the Medicare appeals backlog.  Ms. Brandt offered this insight at the Health Care Compliance Association’s Compliance Institute in Washington, D.C. on March 28, 2017.

The AFIRM Act was originally introduced on December 9, 2015, by Senate Finance Committee Chairman, Orrin Hatch (R-Utah) and Ranking Member, Ron Wyden (D-Ore).  It would have appropriated an additional $127 million annually to clearing the Medicare appeals backlog, with an additional $125 million going to the Office of Medicare Hearings and Appeals (OMHA) and $2 million to the Departmental Appeals Board (DAB). 

It also would have created new Medicare magistrate positions within OMHA to handle reviews with amounts in controversy between $150 and $1,500 and reserved reviews with amounts in controversy greater than $1,500 for administrative law judges (ALJs). The AFIRM Act, notably, would also have created a process whereby an ALJ could certify an appeal for expedited judicial review where there are no material issues of fact in dispute and neither the ALJ nor the DAB has the authority to decide the questions of law or regulation presented.

According to Ms. Brandt, the Committee could also introduce legislation that would amend the Stark Law by the end of 2017.  Senator Hatch previously released a white paper addressing Stark Law reform on June 30, 2016, and the Committee held a hearing to discuss potential changes to the Stark Law following the white paper’s release.  

A copy of the AFIRM Act introduced in 2015 is available here, and a copy of the white paper is available here.