tci Part B Insider - 2010 Issue 19

Fraud and Abuse: Look for Big Compliance Changes Thanks to Healthcare Reform

One guilty-until-proven-innocent provision could shutter some blameless providers, expert says.Under the healthcare reform law's tough new fraud-fighting provisions, regulators will take your money first and ask questions later."The [HHS] Secretary may suspend payments to a provider of services or supplier ... pending an investigation of a credible allegation of fraud against the provider of services or supplier, unless the Secretary determines there is good cause not to suspend such payments," says section 6402 of the Patient Protection and Affordable Care Act (PPACA).The Department of Health and Human Services (HHS) will "consult with" the HHS Office of...

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