Home > Health Law Reform -- General > CMS Proposed Rule on Health Care Reform Act’s Program Integrity Provisions

CMS Proposed Rule on Health Care Reform Act’s Program Integrity Provisions

Healthcare fraud is a multi-billion dollar problem.  The Health Care Reform Act adopts a number of so-called “Transparency and Program Integrity Provisions” to help combat this fraud (Title VI, sections 6001-6703).  While it is easy to conclude that these provisions are another example of the government’s overreaction to an actual problem, healthcare providers cannot ignore them.

On September 23, CMS published in the Federal Register its proposed rule on “Additional Screening Requirements, Application Fees, Temporary Enrollment Moratoria, Payment Suspensions and Compliance Plans for Providers and Suppliers.”  The proposed rule is intended to transition CMS’s antifraud activities from “pay and chase” to fraud prevention.  The complete proposal can be found at http://tinyurl.com/24cv3lw.  Comments have been solicited and must be received no later than November 16, 2010.

Over the next several posts, we will explore the proposed rule and what it means to healthcare providers.

 

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