CMS Steps Up Medicare Revocation Actions

By: Anne Branan

The Centers for Medicare and Medicaid Services (“CMS”) published a final rule, effective February 3, 2015, that drastically expanded CMS’s ability to revoke a provider’s Medicare billing privileges (“Final Rule”). This Final Rule has proved to be a serious thread to providers as CMS uses this new authority to strip more providers of their Medicare billing privileges and provider agreements.

Even before the Final Rule, CMS had a long list of reasons it could rely on to revoke a provider’s billing privileges. However, in the past, CMS may have conducted an audit of the suspect claims and given then provider a chance to explain or correct the claims. But now, CMS appears to favor using revocation to rid the Medicare program of providers it considered to be “bad actors.”

Please click here to view the full article as published by South Florida Hospital News and Healthcare Report.  

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