The Centers for Medicare & Medicaid Services (CMS) announced new rules that increase oversight of Medicare providers. These new safeguards are designed to prevent physicians and other providers with unpaid debt from reentering Medicare, remove providers with patterns or practices of abusive billing, and implement other provisions. CMS said the increased oversight will help save more than $327 million annually.
The new changes, which were announced December 3, allow CMS to:
- Deny enrollment to providers, suppliers, and owners affiliated with any entity that has unpaid Medicare debt; this will prevent people and entities that have incurred substantial Medicare debts from exiting the program and then attempting to reenroll as a new business to avoid repayment of the outstanding Medicare debt.
- Deny or revoke the enrollment of a provider or supplier if a managing employee has been convicted of a felony offense that CMS determines to be detrimental to Medicare beneficiaries. The recently implemented background checks will provide CMS with more information about felony convictions for high-risk providers or suppliers.
- Revoke enrollments of providers and suppliers engaging in abuse of billing privileges by demonstrating a pattern or practice of billing for services that do not meet Medicare requirements.
To read the final rule, 2014-28505, visit www.federalregister.gov/public-inspection.