AFIRM Act

Summary

Audit & Appeals Fairness, Integrity, and Reforms in Medicare Act of 2015 or the AFIRM Act This bill amends title XVIII (Medicare) of the Social Security Act to require the Department of Health and Human Services (HHS) to establish, within the Office of Medicare Hearings and Appeals, decision-making officials to be known as Medicare magistrates. The bill extends training requirements for Administrative Law Judges to Medicare magistrates and establishes additional training for both types of adjudicator. The bill also requires HHS to provide for the annual transfer, from the Federal Hospital Insurance Trust Fund and the Federal Supplementary Insurance Trust Fund, of specified additional funding for Medicare hearings and appeals. HHS shall: establish a process for the referral of cases in which there is a credible suspicion of fraudulent activity to relevant specified agencies; annually publish on its website specified data regarding Medicare appeals; implement a process for identifying inconsistent interpretations of policies in Medicare appeals; establish an optional alternative dispute resolution process for redeterminations and reconsiderations; create guidelines for reviewing claims for payment submitted by providers; designate a point of contact to oversee and undertake several Medicare program integrity initiatives; establish a secure system through which a provider may track the status of a claim for payment that is being audited or processed as an appeal; appoint a Medicare Reviews and Appeals Ombudsman; and establish a compliance incentive program applicable to Medicare review contractors as well as providers. The bill makes several other revisions to Medicare appeals provisions.

This text is taken from the official record. PoliticalRepo does not editorialize.

Timeline

No timeline events have been ingested for this record yet.

Votes

No vote records are attached yet.

Versions

No version snapshots stored. Document URLs remain at the source.

Documents

4 official files

• Placed on Calendar Senate (text)

  Placed on Calendar Senate · EN · 8 December 2015

  ViewDownloadOpen at official source

• Placed on Calendar Senate (PDF)

  Placed on Calendar Senate · EN · 8 December 2015

  ViewDownloadOpen at official source

• Reported to Senate without amendment

  summary · EN · 8 December 2015

  Open at official source

• Introduced in Senate

  summary · EN · 8 December 2015

  Open at official source

Sponsors

No sponsors or actors listed by the source.

Related records

No cross-record relationships stored yet.