Bad Apple Rule Updated by CMS

Managed Healthcare Executive

George B. Breen, Chair of the firm's National Health Care and Life Sciences Practice Steering Committee, and Amy F. Lerman, Associate in the Health Care and Life Sciences practice, in the firm’s Washington, DC, office authored an article in Managed Healthcare Executive, titled “Bad Apple Rule Updated by CMS.”

Following is an excerpt:

The Centers for Medicare and Medicaid Services (CMS) recently issued a final rule that updates requirements for providers wishing to enroll in the Medicare program. The updates, effective February 3, 2015, are the latest in a longstanding effort by CMS to strengthen Medicare program integrity efforts.

Enrollment is a critical gateway to billing the Medicare program and, as such, is carefully scrutinized by CMS to ensure only legitimate providers enroll.