Becker's Healthcare September 6, 2019
CMS released a final rule Sept. 5 that creates several new efforts to address Medicare and Medicaid fraud.
Five things to know:
1. Effective Nov. 4, the final rule outlines new authorities for CMS. The agency can now identify healthcare providers and suppliers who may be at risk of committing fraud based on their relationships with other organizations who have been sanctioned for fraud.
2. Under the final rule, an organization enrolled in the federal Medicare and Medicaid programs can be denied participation in Medicare if its owner or a managing employee is affiliated with another previously sanctioned organization. If the organization is already enrolled and such a relationship is identified, it could lose its Medicare and Medicaid billing privileges.
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