FierceHealthcareFierceHealthITFierceHealthFinanceFierceEMRHospital ImpactFierceMobileHealthcare   FiercePharma

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

Tools
Tags
Social Security Administration
Npi
Medicare Integrity Program
medicare fraud
Medicare Claims
Medicare
Department of Health and Human Services (HHS)
Dead Doctors

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

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

Bookmark and Share
Get Your FREE FierceHealthcare Email Newsletter:
Comments (2) | Post a comment

Comments

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

At last. The new NPI system will finally avoid payments to all doctors. Darrell Pruitt DDS

CMS is continually embarrassed and will be until they are willing to make dramatic changes within their agency. In 1997 CMS was informed of how providers had been ripping off the Medicare system by filing fraudulent cost reports. CMS was reluctant to aggressively pursue the providers and recover the billions swindled from their program. Until CMS wakes up they will continue to be vulnerable to fraud.

John W. Schilling
Author - Undercover
ethicsolutionsllc.com

Post new comment

The content of this field is kept private and will not be shown publicly.

More information about formatting options

To combat spam, please enter the code in the image.