Billing Revocations Surge as CMS Flexes Enrollment Muscle; Appeals Are Little Help

Overview


Tony Maida explained increased efforts by the Centers for Medicare and Medicaid Services (CMS) to strip more providers of their Medicare billing privileges, noting that “CMS is under pretty constant pressure to take more actions against bad providers.” Mr. Maida said that because revocation for repeated noncompliant billing is aimed at providers who continue to submit bad claims in spite of receiving multiple denials, “Sometimes providers don’t change what they are doing, so CMS was looking for a remedy it can exercise.”