Medicare Scam Prosecutions Stepped Up
July 19, 2010
By now you’ve seen the headline, 36 Arrested in Medicare Scams Totaling $251 Million. With 94 suspects indicted and 36 arrested, the perpetrators include clinic owners, medical staff, patients, and more.
Whether or not something occurred at a hospital, the prospect of dealing with an investigation is enough to spur action. The Affordable Care Act gives federal officials to authority to stop paying a provider suspected of fraud, a significant change from the pay first, investigate later position of the past.
The vast majority of vendors and hospitals behave responsibly. But in a stepped up enforcement environment like this, neither side wants to be caught in the middle. A solid vendor compliance program integrates internal and external requirements — from managing the CMS’ monthly sanction list checks to conflict of interest disclosures to linking the individual serving the account to the employer — and protects both the buyer and seller.
Entry Filed under: Medicare/Medicaid CMS, vendor credentials, vendor management. .
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