IRS to Help CMS Fight Fraud
Legislation to temporarily delay Medicare physician payment cuts, passed by Congress and awaiting President Obama’s signature, also establishes a data match program between the Centers for Medicare and Medicaid Services and the Internal Revenue Service to aid in identifying fraudulent providers.
Legislation to temporarily delay Medicare physician payment cuts, passed by Congress and awaiting President Obama's signature, also establishes a data match program between the Centers for Medicare and Medicaid Services and the Internal Revenue Service to aid in identifying fraudulent providers.
The data match provision is an amendment to the health care reform law, under which the IRS is mandated to collect new data from employers and consumers to support the eligibility determination and documentation and verification processes for government-paid premium and cost sharing subsidies, and to fight fraud.
The bill, H.R. 3962, gives the IRS authority to disclose to CMS any information on outstanding tax debts for a provider of services who has applied to enroll or reenroll in Medicare. The bill defines a delinquent tax debt as one for which a notice of lien has been filed. It excludes debts being paid in a timely manner pursuant to an agreement, or debts that are going through a due process hearing and no payment is currently required.
CMS can use information obtained from the IRS in determining whether to deny a provider application for participation in Medicare or to apply enhanced oversight to the provider. Text of the enrolled version of the bill, H.R. 3962, is available at congress.gov.
--Joseph Goedert
The data match provision is an amendment to the health care reform law, under which the IRS is mandated to collect new data from employers and consumers to support the eligibility determination and documentation and verification processes for government-paid premium and cost sharing subsidies, and to fight fraud.
The bill, H.R. 3962, gives the IRS authority to disclose to CMS any information on outstanding tax debts for a provider of services who has applied to enroll or reenroll in Medicare. The bill defines a delinquent tax debt as one for which a notice of lien has been filed. It excludes debts being paid in a timely manner pursuant to an agreement, or debts that are going through a due process hearing and no payment is currently required.
CMS can use information obtained from the IRS in determining whether to deny a provider application for participation in Medicare or to apply enhanced oversight to the provider. Text of the enrolled version of the bill, H.R. 3962, is available at congress.gov.
--Joseph Goedert
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