New Fine & Penalties for Medicare Abuse

In a “change request” that took effect Jan. 15, CMS outlined new steps to identify and discipline “recalcitrant providers,” or those who abuse the program and do not change their inappropriate behavior even after extensive education by Medicare contractors to do so.

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Contractors have placed these providers on prepay medical review for years, which protects Medicare dollars on the front end but exhausts contractor resources that could be utilized in more productive oversight activities, according to CMS.

Read the full report on Becker’s Hospital Review.

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