CMS says new system will avoid payments using dead doctors' names

While probably embarrassed by the revelation that crooks have been profiting handsomely by billing Medicare for equipment prescribed by dead doctors, CMS has a system in place to end the practice. That, at least, is what CMS Deputy Administrator Herb Kuhn told Congress at a Senate Homeland Security and Government Affairs Investigations Subcommittee hearing. Kuhn said that since May, the agency has had a system in place that cross-checks the names of doctors that appear on Medicare claims with the Social Security Administration's database of death reports. Under the new system, all doctors are being assigned a National Provider Identifier, rather than the existing Unique Physician Identifier, and they're making sure that no dead physicians get NPI, Kuhn said.

In defending the agency, Kuhn noted that it didn't consider this type of fraud to be its biggest vulnerability when it made an assessment in 2004. He also noted that the budget for the Medicare Integrity Program, which fights abuse and fraud, hasn't grown from $720 million since 2003. Medicare officials would like to see another $300 million added to fight fraud.

To learn more about this issue:
- read this Kaiser Daily Health Policy Report piece [1]

Related Articles:
Medicare paid almost $100M to dead doctors since 2000, report finds [2]
Medicare fraud costs CMS billions [3]
New HHS program targets Medicare fraud [4]
Medicare fraud growing due to design of IT systems [5]