What's your 'fraud potential'?

Saturday, January 31, 2009

BALTIMORE--The National Supplier Clearinghouse Medicare Administrative Contractor (NSC MAC) will perform “a fraud potential analysis” of all DME applicants and current providers, CMS announced in a Dec. 31 transmittal. The NSC will use four fraud level indicators: low risk, limited risk, medium risk and high risk. In assessing a provider’s fraud level, the NSC MAC will consider things like prior Medicare experience, geographic area, site visit results, inventory observed and contracted, and accreditation.