Bill aims to close 'shocking' healthcare fraud loophole

A congressman has introduced a bill aimed at closing a "shocking loophole" that has led to Medicare and Medicaid fraud and abuse, Kaiser Health News reported March 28. 

The bill from Texas Rep. Lloyd Doggett comes after Kaiser Health News in 2022 found weaknesses that allowed those accused or convicted of fraud to easily sidestep federal bans, according to the report. Among those weaknesses is CMS' lack of authority to deny or revoke National Provider Identifier numbers after regulators have barred a person or business from receiving funds from government payers.  

Mr. Doggett's bill would give CMS the authority to deactivate NPIs tied to anyone convicted of fraud, waste or abuse and whose name appears on HHS Office of Inspector General's exclusions list, according to the report. The bill would also require CMS to implement recommendations made by the inspector general to improve NPI reporting and provider transparency. 

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