Federal Reports

To bill for services they provide to beneficiaries, providers must enroll in Medicare and periodically revalidate this enrollment. Effective enrollment screening is an important tool in preventing Medicare fraud. The Centers for Medicare & Medicaid Services (CMS) has sought to enhance the enrollment screening process with new antifraud tools such as placing providers in risk categories, increasing site visits, requiring fingerprinting, implementing an Automated Provider Screening system, and denying enrollment to providers whose owners have unresolved overpayments. This study examines CMS's early implementation of new screening tools intended to prevent illegitimate providers from enrolling in Medicare.

Non-Bank private mortgage servicers who have already received more than $1 billion from Treasury are increasing their participation in HAMP, which raises risks to homeowners and the need for significant oversight.

Lafayette General Medical Center (the Hospital) (operating in Louisiana) complied with Medicare billing requirements for 34 of the 103 inpatient claims and all 31 outpatient claims. However, the Hospital did not fully comply with Medicare billing requirements for the remaining 69 inpatient claims. On the basis of our sample results, we estimated that the Hospital received overpayments of at least $4.4 million for claims paid during 2013 and 2014.