Increased Scrutiny to Obtain and Maintain Medicare and Medicaid Enrollment – Time to Comment is Now


Several provisions in the recent health care reform legislation were designed to enhance the Medicare and Medicaid enrollment procedures to protect against fraud by prohibiting unqualified individuals and entities from obtaining or maintaining enrollment. Proposed regulations "Medicare, Medicaid, and Children's Health Insurance Programs: Additional Screening Requirements, Application Fees, Temporary Enrollment Moratoria, Payment Suspensions and Compliance Plans for Providers and Suppliers" were published on September 23, 2010, with a 60-day comment period ending November 16, 2010.

In this article, Donna J. Senft of Ober|Kaler provides a glimpse into some of the key provisions in the proposed regulation changes. There are specific rules related to Medicare enrollment as well as rules that state Medicaid programs would be required to implement to get federal financial participation funding.

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DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

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