Regulators have tightened up screening efforts for Medicare providers

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Senate Finance Committee Chairman Max Baucus (D-MT)
Senate Finance Committee Chairman Max Baucus (D-MT)

Regulators have strengthened Medicare provider enrollment and toughened fraud prevention efforts, but it's too early to know how effective the initiatives will be, a new report reveals.

The Centers for Medicare & Medicaid Services is implementing Affordable Care Act-required screening of Medicare providers and suppliers, according to a Government Accountability Office report released Monday. And these efforts are strengthening the quality and timeliness of the data in the Provider Enrollment, Chain and Ownership System (PECOS).

The report, which was prepared for Senate Finance Chairman Max Baucus (D-MT), found that it's too soon to determine if the new provisions “will improve the integrity of the Medicare provider enrollment and claims payment processes and reduce the likelihood of improper payments.” Baucus is holding a hearing today on the issue.

Federal reviewers looked closely at the automated screening contractor, which determines whether Medicare suppliers and providers meet eligibility criteria. Additionally, CMS has moved forward with efforts to establish a national contractor that can conduct physical site visits to all Medicare providers and suppliers to evaluate compliance.

Click here to read the GAO report.