CMS Final Rule Enhances Agency Oversight of Medicare Providers and Strengthens Protections for Medicare Beneficiaries

American Health Lawyers Association

Amy F. Lerman, Associate in the Health Care and Life Sciences practice, in the firm’s Washington, DC, office, authored an article for the American Health Lawyers Association’s Fraud and Abuse Practice Group, titled “CMS Final Rule Enhances Agency Oversight of Medicare Providers and Strengthens Protections for Medicare Beneficiaries.”

Following is an excerpt:

The Centers for Medicare & Medicaid Services (CMS) issued a Final Rule that updates requirements for providers and suppliers wishing to enroll in the Medicare program. CMS published the Final Rule in the Federal Register on December 5. The new regulations the Final Rule creates will be effective February 3, 2015. The Final Rule is the latest development in a longstanding effort by CMS to strengthen Medicare program integrity efforts as part of a comprehensive strategy shaped by the Affordable Care Act, both in terms of protecting Medicare beneficiaries and ensuring that taxpayer dollars are spent on legitimate services and items. The enrollment process for Medicare providers and suppliers is a critical "gateway to billing the Medicare program" and, as such, has been carefully scrutinized by CMS in recent years to ensure that only legitimate providers and suppliers are enrolling in the program.