tci Part B Insider - 2004 Issue 4

PSC Background

The Health Insurance Portability and Accountability Act of 1996 created the Medicare Integrity Program to reduce fraud and abuse in Medicare and gave CMS the authority to contract with entities to battle fraud. The new contractors, called Program Safeguard Contractors, work with the Part B carriers. They do things like medical review, data analysis, provider education and fraud detection.  CMS has named 12 PSCs with national and local responsibilities. Several of them also operate as Part B carriers, including Cahaba GBA, Mutual of Omaha, and Tricenturion, a joint venture that includes Palmetto GBA and Trailblazer Health Enterprises. According...

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