tci Medicare Compliance & Reimbursement - 2020 Issue Q1

Expect More Payment Scrutiny in the Future

New ‘five-pillar’ program aims to cut the rates upfront. Due in part to the skyrocketing costs of healthcare, Medicare wants to reduce improper payments from the get-go. Details: Back in September, the Centers for Medicare & Medicaid Services (CMS) released a final rule in the Federal Register titled “Program Integrity Enhancements to the Provider Enrollment Process.” The rule outlined the agency’s initiative to utilize the Medicare enrollment system to stop fraudsters before they joined the program (see Medicare Compliance & Reimbursement, Vol. 45, No. 18). Now: CMS expanded on this integrity plan with its &ldquo...

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