New healthcare regs target Medicare fraud

Hundreds of pages of draft regulations issued Monday would overhaul the federal Medicare Advantage and Part D prescription drug programs, tackling fraud and saving an estimated $1.3 billion over five years, the Obama administration said.

The U.S. Centers for Medicare and Medicaid Services (CMS) contends the sweeping proposed rule would strengthen consumer protections, while both cutting costs and improving care for enrollees in the programs. 

The changes to the troubled programs would take effect in 2015. The regulations, totaling 678 pages, will be published in Friday’s edition of the Federal Register, starting the clock on a 60-day public comment period that will end on March 7.

If finalized, the regulations would bring physicians under greater federal oversight by demanding that any doctors or “non-physician practitioners” who write prescriptions under Part D program must be enrolled in Medicare.

The move to rein in doctors follows published reports finding fraudulent and abusive prescribing practices.

The proposed rule would also require greater cost savings for beneficiaries, the administration maintains, and would enact a provision of the Affordable Care Act requiring that sponsors of Medicare Advantage Part D plans report and return overpayments. 

If enacted, the regulations would save roughly $1.3 billion over the five years stretching from 2015 to 2019, according to CMS.


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