CMS Announces New Rules to Reduce Fraud and Abuse in Medicare Part D

The White House has released details about new policies meant to save the federal Medicare program $1.6 billion over the next 10 years by reducing fraud in Medicare Part D. The new requirement will force doctors and other health care providers to register with Medicare if they wish to write prescriptions that will be paid through Part D. If a doctor is not registered, the Centers for Medicare and Medicaid Services (CMS) will necessitate them to officially opt-out of the program.

The Obama administration has also added that providers with a history of abuse will be dropped from Medicare enrolment. The new regulations will give the CMS the ability to cancel the enrolment of doctors that have a history of being disciplined by the Drug Enforcement Authority or State licensing boards.

The new rules are expected to go into effect on June 1, 2015 and are part of a final rule that was issued by the CMS. The proposed rules have far reaching effects and are meant to reform the Prescription Drug and Advantage Programs. The 487-page final rule will furthermore include plans to release data about Medicare Part D similar to previous publication of statistics about Medicare payments to doctors.



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