Health Information Management

CMS fraud and abuse teams shuttered by shutdown

APCs Insider, October 4, 2013

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When the federal government shut down October 1 after Congress failed to pass continuing funding measures, many agencies, including CMS, were forced to furlough a large percentage of workers, which could have far-reaching effects on the healthcare industry.

CMS will furlough 65% of its 5,994-person workforce during the shutdown, according to its contingency plan, despite having the most mandatory funding available of all Health and Human Services (HHS) agencies.

Because the shutdown only impacts discretionary funding, CMS says that many programs will continue running without interruption “in the short term.” Those programs include Medicare, Health Care Fraud and Abuse Control, the Center for Medicare and Medicaid Innovation, and Pre-existing Condition Insurance Plan activities.

However, CMS will be forced to discontinue operations related to its healthcare fraud and abuse strike force teams during the shutdown, according to the contingency plan. There would also be fewer recertifications and initial surveys for Medicare and Medicaid providers, according to CMS, which would put beneficiaries at risk of quality of care deficiencies. 



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