U.S. Representatives Peter J. Roskam and Patrick Tiberi, respectively Chairmen of the Ways & Means Subcommittees on Oversight and Health, sent a letter to the Centers for Medicare and Medicaid Services (CMS) requesting additional information regarding CMS's decision to temporarily pause reviews of inpatient hospital short stay claims due to improper auditing.
Chairman Roskam released the following statement:
"CMS's announcement is significant because of the agency's troubled record of improperly overseeing payments of short stay hospital admissions.
"An improper payment rate of 6.2 percent for inpatient hospital services - which roughly translates to $7 billion of taxpayer funds - is unacceptable and American taxpayers deserve better. CMS's decision to pause new reviews in order to reevaluate previous claims raises legitimate oversight questions.
"We need more answers about the factors leading up to the October decision to institute a new auditing structure for hospital short stay claims and what, if any, consideration or guidance was provided to ensure claims were audited in a consistent and accurate manner. I look forward to hearing from CMS soon about the events and decisions which preceded their recent determination to review these claims."