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Capitol Health Call
May 8, 2013

Medicare Waste and Abuse

JAMA. 2013;309(18):1885. doi:10.1001/jama.2013.4941

Some of the tools provided by the Patient Protection and Affordable Care Act (ACA) to safeguard the Medicare program from waste, fraud, and abuse are not being used by the Centers for Medicare & Medicaid Services (CMS) to reduce the problem, said 3 Republican senators.

Sen Tom Coburn (R, Okla), Sen Chuck Grassley (R, Iowa), and Sen Orrin Hatch (R, Utah) said in a March 28 release that under the ACA, CMS can impose a temporary enrollment moratorium on new Medicare providers, such as hospitals, skilled nursing homes, rural health clinics, and suppliers in areas identified by the agency as high risk for waste, fraud, or abuse. Although evidence uncovered from investigations by the Department of Health and Human Services (HHS) Office of Inspector General suggested that a moratorium would curb Medicare fraud, CMS has failed to exercise its authority to impose a single temporary moratorium, the senators said.