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Medicare Compliance & Reimbursement

Compliance:

New HHS Suspension Powers Can Create Havoc For Your Income

Published on Sun Nov 11, 2012

Gear up for more stringent anti fraud enforcement after the Oct. 4 crackdown.The Department of Health and Human Services and the Centers for Medicare & Medicaid Services sent out a chilling message to fraudsters to mend their ways when 91 people were indicted in Medicare fraud schemes totaling $492.2 million, (see Medicare Compliance & Reimbursement, v 38, n 20.)In addition to formal indictments, CMS suspended Medicare payments and took other administrative actions against 30 health care providers "following a data-driven analysis and based upon credible allegations of fraud," the Department Of Justice said in an Oct. 12 news release.What is unclear is whether the providers CMS suspended are under indictment. The DOJ notes that "under the Affordable Care Act, HHS is able to suspend payments until the resolution of an investigation."But in the release, HHS Secretary Kathleen Sebelius says "HHS used new authority from the health care law to stop [...]
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