OMB Finishes Review of Final Rule Aimed at Fraudulent Medicare Providers
Final rule may be published soon
November 17, 2014 11:26 AM
Bloomberg BNA recently reported that the White House Office of Management and Budget (OMB) has completed its review of a final rule that is aimed at combating Medicare fraud. OMB review is one of the last steps before such rules are published in the Federal Register.
The Bloomberg BNA article details the Final Rule and the OMB’s review:
“According to OMB's reginfo.gov site, the OMB finished its review of the rule Nov. 12. The OMB said the rule (CMS-6045-F) from the Centers for Medicare & Medicaid Services “helps to ensure that potentially fraudulent entities and individuals do not enroll in or maintain their enrollment in the Medicare program.”
The rule, Requirements for the Medicare Incentive Reward Program and Provider Enrollment, is economically significant. The OMB began its review in August (156 HCDR, 8/13/14).
The proposed version of the rule (CMS-6045-P) was published April 29, 2013 (78 Fed. Reg. 25,013) (80 HCDR, 4/25/13). Comments were due in June 2013.
The proposed rule would raise the maximum reward for successful Medicare fraud tips from $1,000 to $9.9 million.
At the time of the proposal, the CMS said its Medicare Incentive Reward Program (IRP) was created under the authority of Section 203(b)(1) of the Health Insurance Portability and Accountability Act, which said the health and human services secretary should implement a program to reward individuals who report potential Medicare fraud.
The CMS said the proposed change to the Medicare IRP, to boost the rewards, was based on a reward program run by the Internal Revenue Service, which pays individuals who provide tips on violations of the IRS code. “We believe this proposed rule would increase the incentive for individuals to report information on individuals and entities that have or are engaged in sanctionable conduct; improve our ability to detect new fraud schemes; and help us ensure that fraudulent entities and individuals do not enroll in or maintain their enrollment in the Medicare program,” the CMS said in the proposed rule.”
NAHC staff continues to monitor for the publication of the Final Rule to combat Medicare fraud. Any future updates will be published in NAHC Report when more information becomes available.