CMS to focus anti-fraud efforts on seven states

CMS is continuing to move ahead with its latest round of fraud-fighting efforts with a new focus on durable medical equipment suppliers and home health care agencies. The agency is paying special attention to DME suppliers in California, Florida, Illinois, Michigan, New York, North Carolina and Texas, subjecting suppliers in those states to deeper examinations of their claims. CMS will also conduct deeper background checks on DME suppliers, make unannounced visits to ensure that suppliers are actually in business, and conduct interviews with beneficiaries to see if they're getting supplies ordered for them.

Meanwhile, CMS will take special steps to fight fraud by Florida-based home health agencies, specifically those who say they're providing services for sicker-than-average beneficiaries. Such cases represented 60 percent of all home care claims paid by Medicare in Miami last year, as compared with the national average of 6 percent, according to CMS acting administrator Kerry Weems. With South Florida's breathtaking history of Medicare fraud, this is less surprising than it seems, but still a fairly remarkable stat. Let's see whether CMS's new program can put a dent in this little regional cottage industry, much less seven states or the entire U.S.

To learn more about CMS's latest fraud-fighting efforts:
- read this Kaiser Daily Health Policy Report piece

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