“CMS CRUSH initiative alone not sufficient to fight fraud, groups say,” by Kathleen Steele Gaivin, McKnights Senior Living
“Fraud must be rooted out, but the Comprehensive Regulations to Uncover Suspicious Healthcare, or CRUSH, initiative proposed by the Centers for Medicare & Medicaid Services alone isn’t the answer, according to senior living and care industry advocates. … The initiative focuses on artificial intelligence-driven fraud detection, real-time payment monitoring, improved interagency data sharing and greater transparency regarding providers that have had their billing privileges revoked by CMS. … LeadingAge Vice President of Policy and Government Affairs Mollie Gurian wrote in a March 30 letter to CMS Administrator Mehmet Oz, MD. ‘A solution is not effective if it chills the interest of providers from entering a market where there is genuine need or if it causes existing quality providers in that space enough extra burden that they may cease operations.’”
LTC Comment, Stephen A. Moses, President, Center for Long-Term Care Reform:
Translation: don’t do anything to discourage bad actors from getting on the government health care gravy train because it might somehow discourage responsible providers and caregivers from offering their legitimate services. Sounds a little like “defund the police.”