CMS Addresses Medicare Fraud

CMS Attempts to Curb Medicare Fraud

The Centers for Medicare and Medicaid Services (CMS) is issuing new rules to help prevent Medicare fraud and abuse by barring physicians with unpaid debt from re-entering the system and ejecting providers who have a history of abusive billing practices, according to a statement  released Wednesday.

"CMS has removed nearly 25,000 providers from Medicare and the new rules help us stop bad actors from coming back in as we continue to protect our patients," Shantanu Agrawal , MD, CMS deputy administrator and director of the Center for Program Integrity, said in the statement.

The agency’s strategy  for curbing unscrupulous providers includes using new predictive analytics technology, implementing fingerprint-based criminal background checks, and temporarily freezing enrollment of new ambulances and home health providers in seven "fraud hot spots."

The new regulations are expected to save taxpayers more than $327 million each year.

via D.C Week: CMS Addresses Medicare Fraud, ACO Penalties.

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