Medicare moves to boot bad actors

Federal health officials are moving to curb fraud and abuse in Medicare with new rules cracking down on providers with a history of bad practices.

The Centers for Medicare and Medicaid Services (CMS) will now boot providers or suppliers if a managing employee was convicted of a felony offense deemed harmful to Medicare beneficiaries.


The agency will also deny enrollment to providers affiliated with entities that carry unpaid Medicare debt. This action is designed to prevent people from exiting Medicare with debt and re-entering the program as a new business to avoid payment.

Providers and suppliers who have repeatedly billed Medicare for services not covered by the program could also see their enrollment revoked, according to the rules.

"The changes announced today are common-sense safeguards to preserve Medicare for generations to come, while making the rules more consistent for all providers that work with us," said CMS Administrator Marilyn Tavenner in a statement.

The 140-page document, released Wednesday, outlines authorities granted to CMS under the federal healthcare law. The agency estimated that its new actions will save Medicare $327 million annually.

The agency did not finalize its Incentive Reward Program due to "the complexity of the operational aspects of our proposal," but said it could in future rulemaking.