Mayor Asks Lamar Alexander to Hold Senate Hearings to Revoke Obama-Era Regulation That Permits CMS Abuse of Medicare Billing Cases

The mayor of McKenzie, Tennessee asked Senator Lamar Alexander (R-TN) to hold Senate hearings on the abuse of Medicare billing revocations by the Centers for Medicare and Medicaid Services [CMS] in a letter sent on Wednesday.

Writing “on behalf of the citizens of Northwest Tennessee,” Mayor Jill Holland asked Alexander, “as Chairman of the Senate Health, Education, Labor, and Pensions Committee [to] schedule, at the earliest opportunity, a hearing of the appropriate subcommittee to consider the revocation or modification of a particularly egregious Obama-Era regulation promulgated by the Centers for Medicare and Medicaid Services (CMS) in December, 2014, “Medicare Program; Requirements for the Medicare Incentive Reward Program and Provider Enrollment; Final Rule.”

“This regulation, and its abusive implementation by CMS, is now jeopardizing the health care of hundreds of eventually thousands of citizens in and around McKenzie, Tennessee, our city of 5,000 residents in Carroll, Henry, and Weakley counties,” Holland wrote.

Holland then cites the case of Dr. Bryan Merrick, a beloved local family doctor who has practiced medicine in McKenzie for more than thirty years with an unblemished reputation.

Merrick is the West Tennessee doctor who “lost his Medicare reimbursement privileges over $670 in billing errors, and the consequences are devastating for his practice and the rural community he serves,” as The Tennessee Star reported earlier this month.

“On March 17th of this year, CMS sent Dr. Bryan Merrick a letter revoking his Medicare billing privileges based upon this regulation’s vague standard,” Holland wrote, adding:

The “pattern” cited resulted from an audit of Dr. Merrick and his McKenzie Medical Center covering a 20-month period that found 30 incorrect billings for 10 patients, less than one-tenth of 1 percent of 30,000 claims on behalf of a number of providers and Dr. Merrick.

The clerical errors, for example, mixed up two patients with the same name. Five of the ten patients involved a review of medical records for non face-to-face chronic care management services for patients whom the McKenzie Medical Center did not know had died, some of whom CMS also instructed Dr. Merrick’s clerical staff to bill again as being in hospice care when in fact the patients had died.

Dr. Merrick did not receive a single penny from these 30 claims in question, amounting to less than $1,000.00 because the clerical errors were identified as such prior to the issuance of the payments.

“It’s hard to believe that something like this could happen in this country,” Merrick, a native of Missouri who moved to Arkansas and then to Memphis, where he attended medical school at the University of Tennessee told The Star earlier this month.

Merrick appealed the decision by the Centers for Medicare and Medicaid Services (CMS) to revoke his privileges but his appeal was denied in August. He next plans to go before an administrative law judge.

“I’m hoping this will get resolved,” he said, adding that he doesn’t want to interrupt relationships with patients that go back 20 or 30 years.

In her letter to Senator Alexander, Mayor Holland cut to the core of the issue. This new Obama-era regulation, she wrote, was adopted by Washington bureaucrats who paid no attention to the real world advice of physicians who immediately understood its potential for abuse during the rulemaking process that began in 2013 and ended in December 2014.

“After this regulation was proposed at the beginning of the regulatory process by CMS in April 2013, a number of organizations and physicians vigorously opposed the proposed regulation, particularly the section of the proposed regulation that related to the revocation of Medicare privileges,” Holland wrote.

“The American Academy of Family Physicians, for instance, offered this eerily insightful objection to the regulation in June 2013: . . .’Despite CMS’s assertion that it would not use this provision to revoke providers and suppliers for isolated and sporadic claim denials or innocent errors in billing, there are no mechanisms or safeguards to prohibit CMS or its multiple contractors from doing so. In addition, CMS, did not include in the proposed regulation a thorough discussion of the factors that would supposedly by used in making this determination’, ” she continued.

“Unfortunately, CMS completely ignored these warnings filed during the public comment of the rule-make proceedings and proceeded with the promulgation and finalization of the harmful rule,” Holland noted.

“Please act immediately and conduct hearings on this regulation and issue before the federal government takes our physician away,” Holland asked Senator Alexander in the conclusion of her letter.

Dr. Merrick and several of his supporters, including Mayor Holland, met with Rep. David Kustoff (R-TN-08) last week to ask for his assistance in correcting this abuse of the power of big government inflicted upon Dr. Merrick and his patients. That meeting, however, proved disappointing, as Rep. Kustoff and his staff offered their assistance only in expediting the administrative law hearing process, which usually takes as much as two years to complete.

Despite several attempts over the past several weeks to receive a response for assistance from Senator Alexander, Dr. Merrick has yet to hear from either him or his staff.

Alexander has apparently been preoccupied with his recent attempts to form a bipartisan effort to pass legislation designed to save Obamacare for another two years.

You can read the complete letter sent by Mayor Holland to Senator Alexander below:

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