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CodeMap® Compliance Briefing: 10/04/2010


Editor's Welcome

Recently, CMS published a proposed rule to implement many of the significant anti-fraud provisions included in the recently enacted Affordable Care Act. These anti-fraud measures have the potential to seriously impact the operations of diagnostic providers. The proposed rule contains provisions concerning the screening of providers enrolling or revalidating enrollment in Medicare and Medicaid, application fees to participate in the Medicare and Medicaid programs, the ability of CMS to suspend both enrollment and payments for a variety of fraud-related reasons, and mandatory compliance programs. As this list indicates, the proposed rule covers a lot of territory, and we will be discussing it, and the forthcoming finalized version, for months to come. Over the next two weeks, we will begin with an examination of the screening methods CMS proposes to ensure only ethical and competent providers participate in federally funded health care programs. This week, we will discuss risk classification and screening, and next....

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