CMS Misses Fraud Prevention Deadline - LTCAdministrator.com

CMS Misses Fraud Prevention Deadline

The Centers for Medicare & Medicaid Services (CMA) were required to submit a report to Congress on October 1st reviewing their fraud prevention system (FPS), yet the report has still not been submitted.

On October 15th, two Senate Finance Committee members issued a request for the report, mandated by the Affordable Care Act, to be submitted within three days. Orrin G. Hatch (R-Utah) and Sen. Tom Coburn (R-Okla.) are concerned that the screening system has not been effective in identifying fraud among Medicare providers since its implementation late last year.

In addition to concerns regarding the efficacy of the FPS system, Hatch and Coburn are also troubled by public use of information from the system.  In their letter they said, “… given the detailed statements by CMS staff in public speeches about the results of the FPS, it seems odd that specific details can be shared in public remarks yet you seek to keep the Congressional committee of jurisdiction in the dark.”

It remains to be seen what the response of CMS might be, or what their report will ultimately show about the validity of the FPS system and its effectiveness in actually reducing fraud.  This is the second request for information following a July 31st inquiry.  CMS had agreed to publish a report by the end of September, and they have not responded to this latest request for information.

18. October 2012 by Ruth Folger Weiss
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