The CMS has rolled out a proposed rule carrying out provisions of the national health reform law intended to keep criminals from billing federal health programs and help the government stop paying fraudulent bills.
The provisions of the Patient Protection and Affordable Care Act at issue allow the HHS secretary to suspend payment on claims connected to credible allegations of fraud until an investigation is complete.
Peter Budetti, deputy administrator of the CMS' Center for Program Integrity, said in a call
with reporters that the credibility of allegations would be determined in careful consultation with HHS' inspector general's office. “We wish to assure the provider community this is going to be implemented in a way that will be responsible,” Budetti said.