Health Care Law Protects Against Fraud, Saves Nearly $1.6 Billion Law Requires Stronger Standards for Ordering and Certifying Medical Services, Equipment, and Supplies On April 24, CMS announced a final rule that prevents fraud in Medicare and is estimated to save taxpayers nearly $1.6 billion over 10 years.
This rule ensures that only qualified, identifiable providers and suppliers can order or certify certain medical services, equipment and supplies for people with Medicare. The rule also helps ensure beneficiaries receive quality care because CMS will verify the credentials of a provider who is ordering or certifying equipment and supplies. In addition, the final rule continues to require that all providers and suppliers who qualify for a unique identification number - the National Provider Identifier (NPI) - include their NPI on applications to enroll in Medicare and Medicaid and on all reimbursement claims submitted. This gives CMS and States the ability to tie specific claims to the ordering or certifying physician or eligible professional and to check for suspicious ordering activity. This rule builds on the work CMS is also doing in Medicare Part D by requiring that all prescriptions include an NPI for prescribing physicians. In conjunction with Part D, these efforts will help better safeguard the Medicare Trust Funds by giving CMS the ability to know which providers are ordering, certifying, and prescribing items and services to Medicare beneficiaries. To see the final rule, visit the Office of the Federal Register website<http://www.ofr.gov/(X(1)S(0zb1byigcunulpmhwyfk4g00))/inspection.aspx?AspxAutoDetectCookieSupport=1>. Full text of this excerpted CMS press release<http://www.cms.gov/apps/media/press/release.asp?Counter=4342&intNumPerPage=10&checkDate=&checkKey=&srchType=1&numDays=3500&srchOpt=0&srchData=&keywordType=All&chkNewsType=1%2C+2%2C+3%2C+4%2C+5&intPage=&showAll=&pYear=&year=&desc=&cboOrder=date> (issued April 24). ________________________________ If you know someone who would like to subscribe to a Medicare Fee-For-Service (FFS) provider listserv, go to http://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/downloads//MailingLists_FactSheet.pdf<http://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/downloads/MailingLists_FactSheet.pdf> . If you would like to unsubscribe from a specific provider listserv, please go to (https://list.nih.gov/cgi-bin/wa.exe?INDEX) to unsubscribe or to leave the appropriate listserv. Please DO NOT respond to this email. This email is a service of CMS and routed through an electronic mail server to communicate Medicare policy and operational changes and/or updates. Responses to this email are not routed to CMS personnel. Inquiries may be sent by going to (http://www.cms.gov/About-CMS/Agency-Information/ContactCMS/index.html). Thank you.
