CMS Program Integrity Final Rule

Published: 09/06/2019

  • Centers for Medicare and Medicaid Services
Relevant To:
  • All Healthcare Organizations

The Centers for Medicare & Medicaid Services (CMS) has issued a final rule intended to strengthen the agency’s ability to stop fraud before it happens by keeping “unscrupulous providers” out of federal health insurance programs. This new final rule changes the approach in fraud prevention – moving from “pay and chase” to a methodology that is intends to stop fraudsters before they get paid. 

The final rule, Program Integrity Enhancements to the Provider Enrollment Process (CMS-6058-FC), creates s

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