CMS Cracks Down on Unethical Practices

By Dana Spector, Associate Managing Editor, AHC Media

Late last week, CMS proposed a new rule to further crack down on “questionable providers and suppliers” engaging in unethical practices.

These questionable parties and their actions could place unnecessary risk and strain on Medicare. CMS also provided an infographic and enumerated six major new provisions.

• Different Name, Numerical Identifier, or Business Identity
• Abusive Ordering/Certifying
• Increasing Medicare Program Re-enrollment Bars
• Other Public Program Termination
• Expansion of Ordering/Certifying Requirements

CMS’s intention is to decrease potential fraud.

For more information from CMS:

Helpful Weblinks:

Program Integrity (PI) Provider Enrollment Process (CMS-6058-P) at Federal Register: https://s3.amazonaws.com/public-inspection.federalregister.gov/2016-04312.pdfand on 3/01/2016 and available online at http://federalregister.gov/a/2016-04312

AHC Media has been following changes to the medical ethics and quality review sectors for years. Read more at Medical Ethics Advisor and Hospital Peer Review.