Dive Brief:
- CMS is adopting stricter rules aimed at stopping physicians and other providers with unpaid Medicare fines from re-entering the program; and at removing providers with patterns or practices of abusive billing.
- CMS will now deny enrollment to providers, suppliers and owners affiliated with any entity that has unpaid Medicare debt in order to stop people and businesses from exiting the program and then re-enrolling as a new business to avoid paying what they owe.
- "The changes announced today are common-sense safeguards to preserve Medicare for generations to come, while making the rules more consistent for all providers that work with us," CMS Administrator Marilyn Tavenner said.
Dive Insight:
Medicare fraud is a decades-old problem, so any move to keep out the financial swindlers is a good one. Since the creation of Medicare in 1966, CMS has removed nearly 25,000 providers from the program for a variety of inappropriate activity, according to reports.
"The new rules help us stop bad actors from coming back in as we continue to protect our patients," Dr. Shantanu Agrawal, a CMS deputy administrator and director of the Center for Program Integrity, said in a statement. "For years, some providers tried to game the system and dodge rules to get Medicare dollars."
