
                         Roanoke Times
                 Copyright (c) 1995, Landmark Communications, Inc.

DATE: SUNDAY, March 1, 1992                   TAG: 9203010062
SECTION: NATIONAL/INTERNATIONAL                    PAGE: A-1   EDITION: METRO 
SOURCE: The New York Times
DATELINE: WASHINGTON                                LENGTH: Medium

MEDICARE OVERCHARGES NOT REFUNDED

Despite a federal law intended to protect Medicare patients against excessive doctors' bills, many patients have been overcharged and have been unable to get refunds or assistance from the government, say state insurance commissioners and the beneficiaries themselves.

Part of the problem is that, for more than a year, Medicare officials have used inaccurate, misleading language on forms sent to beneficiaries who filed claims. After a reporter made inquiries, the officials promised late last week to correct these forms and to be more diligent in monitoring doctors' billing practices.

Another part of the problem, still unresolved, is that Medicare officials contend they lack the authority to require doctors to make refunds to illegally overcharged patients. As a result, Medicare beneficiaries will still have to take the initiative in challenging overcharges on doctors' bills.

The law setting limits on what doctors may charge Medicare beneficiaries took effect in January 1991. It has not been vigorously enforced, in part because Medicare officials were unsure of their legal authority and allowed some overcharges to go unchallenged.

The limits on doctors' charges to Medicare beneficiaries were part of a 1989 law that prescribed a new method of paying doctors; it was an effort to slow the rapid growth in Medicare spending for doctors' services. Congress wanted to be sure that doctors losing money under the new fee schedule would not try to offset their losses by raising their charges to Medicare patients.

But most of the 34 million elderly and disabled people on Medicare are unaware of the law, and the government has done little to publicize it. Indeed, the government disseminated erroneous information throughout 1991 because the forms sent to beneficiaries were not updated to take into account the new limits on doctors' charges.

by CNB