HHS and CMS Tout Efforts to Fight Fraud
by Jeff Porter
In a press release published January 24, 2011, the U.S. Department of Health and Human Services is touting its efforts to reduce health care fraud, waste and abuse in the Medicare, Medicaid and Children’s Health Insurance Program (“CHIP”). According to the figures released on Monday, in fiscal 2010, the government’s health care fraud and enforcement efforts resulted in a recovery of more than $4 Billion. Bigger recoveries are expected in 2011 due to new tools provided in the Patient Protection and Affordable Care Act (“Affordable Care Act”), which was passed earlier in 2010.
CMS has promulgated new regulations in order to move forward with the mandates contained within the Affordable Care Act. Among the new tools that may be utilized are a more rigorous screening process for providers enrolling in the Medicare, Medicaid or CHIP programs, temporary halts to payments, new enrollment of providers and suppliers, and use of a new enrollment process for Medicaid and CHIP providers. A copy of the new CMS regulations
can be found online. CMS will receive public comment on certain elements of the new regulations for 60 days.
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