CMS Issues Proposed Fraud and Abuse Provisions

On September 23, 2010, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule that would implement certain fraud and abuse provisions of the Patient Protection and Affordable Care Act (PPACA). These provisions were included in PPACA as a way to help reduce the costs of reform. CMS stated that the provisions “are of critical importance in the transition of CMS’ antifraud activities from ‘pay and chase’ to fraud prevention.” As such, the proposed rules are focused on measures to prevent the enrollment of fraudulent providers and suppliers and the payment of improper claims, as opposed to remedial measures.

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