Legislation would scrutinize long-term care owners

Share this content:

The Centers for Medicare & Medicaid Services would have to more scrupulously verify that providers are not owned by people with a history of fraud, if a recently introduced House bill becomes law.

A current concern is that Medicare fraudsters “could potentially get back into the program” by using a different name and not disclosing their previous affiliations, according to a press release issued Tuesday by Rep. Ted Deutch (D-FL). He and co-sponsor Rep. Peter Roskam (R-IL) have introduced the Stop Schemes and Crimes Against Medicare and Seniors Act (SCAMS) to address this issue by mandating that CMS use a variety of databases to verify ownership.

The legislation also would beef up Congressional oversight over the rollout of new medical code sets. Providers have been critical of CMS efforts in implementing a new version of International Classification of Diseases codes. The ICD-10 implementation was delayed by a year and now is scheduled for Oct. 1, 2015.

The Stop SCAMS Act also calls for the Medicare Payment Advisory Commission to conduct a study on how fraud prevention can be improved, and then issue any recommendations for legislative or administrative action that it “determines appropriate.”

A Senate version of the SCAMS Act was introduced in May by Aging Committee leaders Sens. Bill Nelson (D-FL) and Susan Collins (R-ME). Click here to access the full text of the House version.