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Senators Raise Questions on Oversight for Felons Enrolling in Medicare

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Sens. Orrin Hatch (R-Utah) and Tom Coburn, MD (R-Okla.) have questioned CMS about oversight for its efforts to exclude convicted felons from the Medicare program, according to an American Medical News report.

The senators have asked CMS to crack down on the dozens of convicted felons who are apparently still enrolled in Medicare and able to bill the government for services. The senators said they were concerned about the agency's ability to protect seniors and taxpayer dollars and that "a change is needed to protect the public trust," according to the report.

CMS has taken steps to improve program integrity in recent years, according to agency officials. Of the 34 individuals targeted by the senators in a September letter, seven had no enrollment records with CMS, eight others had no potential from exclusion from the program and one was pending for a possible ban. The rest of the individuals on the senators' list had convictions that were not grounds from exclusion from Medicare — or had no record of conviction in the OIG's database.

Donald Berwick, MD, said CMS has added safeguards to strengthen and protect its enrollment processes in recent years.

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