New CMS Rule Aims to Improve Medicare and Fight Fraud
- United States
- 06/01/2010
On May 5, 2010, the Department of Health and Human Services (HHS) issued an Interim Final Rule with Comment aimed at strengthening Medicare and fighting fraud. Effective July 6, 2010, all Medicare and Medicaid enrollment applications and claims must include the providers’ National Provider Number (NPI); physicians and eligible professionals must be Medicare-enrolled to order or refer covered items or services; and physicians and suppliers must maintain and provide access to documentation on high-risk referrals, such as DMEPOS and home health services.
The Centers for Medicare and Medicaid Services (CMS) may revoke enrollment up to one year for providers who fail to comply with the Rule. According to CMS, however, most enrolled Medicare and Medicaid providers affected by the Rule are already in compliance. To read more about the requirements imposed in the Interim Final Rule, please click here for summer associate Brandi Thompson’s full summary.
