CMS Proposes Medicare Compliance Changes

By Staff Writer

May 21, 2007 at 09:22 PM

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Federal officials say they will keep closer tabs on private companies that run Medicare plans and Medicare prescription drug plans.

The Centers for Medicare and Medicaid Service announced today that it is proposing new compliance requirements for vendors in the Medicare Advantage and Medicare Part D prescription drug plan programs.

The CMS now will take "new steps to help expose potential fraud or misconduct through mandatory self-reporting," officials say.

The CMS also will streamline the process for imposing intermediate sanctions and clarify the process for imposing civil money penalties, officials say.

The proposed rule will be subject to a 60-day comment period, officials say.

The CMS announced the proposed rule as members of the House Ways and Means Committee health subcommittee prepared to gather Tuesday for a hearing on Medicare Advantage fee-for-service plans.

The New York Times recently drew lawmakers' attention to private FFS plans by publishing a front-page article about marketing problems involving private Medicare FFS plans and, in some cases, the more common private Medicare managed care plans.

Some critics of private Medicare plans have been calling for Congress to shift some federal Medicare Advantage program funding into health insurance programs for children and for low-income adults.

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