Home Health & Hospice Week

New anti-fraud regs increase CMS's reach to combat fraud and abuse. A disgruntled employee or competitor who calls a fraud hotline could bring down your company under a new payment suspension proposal. In the past, HHAs and beneficiaries who have tried to report Medicare fraud have complained that their information has fallen on deaf ears. But now the feds might be going too far in the other direction. The Centers for Medicare & Medicaid Services has proposed a number of anti-fraud regulations based on the health care reform law, including new authority to impose payment suspensions on suspicious Medicare providers. To trigger the suspension, CMS would have to have a "credible allegation of fraud," according to the proposed rule published in the Sept. 23 Federal Register. Credible allegations of fraud can come from fraud hotlines, claims data, audits, qui tam cases, law enforcement investigations, and other sources, CMS says in [...]