The Centers for Medicare & Medicaid Services (CMS) issued a final rule that strengthens the agency’s ability to stop fraud before it happens by keeping unscrupulous providers out of federal health insurance programs. A new “affiliations” authority in the rule allows CMS to identify individuals and organizations that pose an undue risk of fraud, waste, or abuse based on their relationships with other previously sanctioned entities.
For example, a currently enrolled or newly enrolling organization that has an owner/managing employee who is “affiliated” with another previously revoked organization can be denied enrollment in Medicare, Medicaid, and CHIP or, if already enrolled, can have its enrollment revoked because of the problematic affiliation. Read a CMS press release.
SMP Resource Center products often contain links to copyrighted material. The SMP Resource Center is providing these links as a convenience and for informational purposes in our efforts to report and educate on Medicare fraud; they do not constitute a guarantee, endorsement, or approval by SMP of any of the information available on the external site. SMP bears no responsibility for the accuracy, legality, or content of the external site or for that of subsequent links. If you have any questions or concerns about the links provided, please contact the SMP Center at nliebau@smpresource.org.