New rules make it harder to cheat Medicare

New regulations aimed at curbing fraud related to the Medicare and Medicaid programs, which amounts to $55 billion annually, have just been revealed.

The new regulations include immediately suspending payments to providers when a “credible allegation” of fraud is made, including tips from consumers; requiring state Medicaid programs to refuse providers who have been rejected by Medicare or another state’s Medicaid or Children’s Health Insurance Program; physically auditing providers’ places of business to ensure they are legitimate; and ranking providers according to their risk of engaging in fraudulent behavior and fingerprinting them and conducting background checks on the riskiest.