CMS revokes 14,000 Medicare provider licenses since ACA

data released by the Centers for Medicare & Medicaid Services (CMS). Over the last four years, the Obama administration has recovered over $14.9 billion in healthcare fraud judgments, settlements, and administrative impositions, including record recoveries in 2011 and 2012. Since the Affordable Care Act, CMS has revoked 14,663 providers and suppliers’ ability to bill in the Medicare program since March 2011. These providers were removed from the program because they had felony convictions, were not operational at the address CMS had on file, or were not in compliance with CMS rules. In 18 states, the number of revocations has quadrupled since CMS put the Affordable Care Act screening and review requirements in place, as well as the implementation of proactive data analysis to identify potential license discrepancies of enrolled individuals and entities. These efforts are ensuring that only qualified and legitimate providers and suppliers can provide health care products and services to Medicare beneficiaries According to the press release, people with Medicare will soon see in their mailboxes a redesigned statement of their service claims and benefits to help them better identify fraud. “The New Medicare Summary Notice gives seniors and people with disabilities accurate information on the services they receive in a simpler, clearer way,” said CMS Administrator Marilyn Tavenner. “It’s an important tool for staying informed on benefits, and for spotting potential Medicare fraud by making the claims history easier to review.” CMS will send the notices to Medicare beneficiaries on a quarterly basis. “A beneficiary’s best defense against fraud is to check their Medicare Summary Notices for accuracy and to diligently protect their health information for privacy,” said Peter Budetti, CMS deputy administrator for program integrity. “Most Medicare providers are honest and work hard to provide services to beneficiaries,” added Budetti. “Unfortunately, there are some people trying to exploit the Medicare system.”]]>