Information on the CMS Fraud Prevention: Automated Provider Screening and National Site Visit Initiatives
INDUSTRY NEWS TAGS: CMS
The National Fraud Prevention Program (NFPP) initiative will assist CMS in its efforts to prevent fraud and abuse in the Medicare program starting with the enrollment process itself. This article describes two new processes that CMS now employs as part of the provider enrollment process:
• Automated Provider Screening (APS) will validate provider and supplier enrollment application information using various public and private databases as well as automatically check other referential databases.
• CMS has implemented a site visit verification process using a National Site Visit Contractor (NSVC). The site visit verification process is a screening mechanism to prevent questionable providers and suppliers from enrolling in the Medicare program.
This NFPP is intended to protect the Medicare Program and to ensure that correct Program payment is made only for covered appropriate and reasonable services provided to Medicare beneficiaries by legitimate providers of care.