On alert: CMS opens new fraud office

Sunday, September 30, 2007

NEW YORK - CMS opened a new office in New York City to track down fraud and abuse, especially for home medical equipment, providers learned after reading a recent newspaper column.
Members of the New York Medical Equipment Association (NYMEP) weren't notified by CMS about the new office, according to Carol Napierski, executive director.
"I found out about it when one of our members let me know it was in the newspaper," she said. "We know very little about it. We're not sure if it's a strategic move from one metro area to another or if it's triggered by any kind of data mining."
Newsday reported Aug. 18 that CMS opened the office in a column called "Gray Matters" by Saul Friedman. Kimberly Brandt, CMS's director of program integrity, told Friedman that the agency's decision to open a new office in New York City had to do, in part, with its recently announced two-year fraud and abuse demonstration project in the Miami and Los Angeles areas.
Friedman wrote: "Depending on what the New York office finds in its initial investigations, CMS may launch an intensive monitoring program in the city similar to the pilot program and expand it to the suburbs and beyond."
Already, providers in New York are part of a CMS demo that uses private companies to perform post-payment medical reviews.
"We're going to see how this plays out," Napierski said.