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Monday, September 10, 2012

TMA: Medicaid Inspectors’ Proposals Go Way Too Far

In a strongly worded 35-page letter to the Health and Human Services Commission, TMA is opposing proposed new “program integrity” rules that cast every Medicaid billing error as a possible target for fraud-and-abuse prosecution. “TMA strongly opposes the proposed rules because they expand [the Office of Inspector General’s] authority, minimize the rights of physicians and other providers, and have a tenor that implies a presumption of wrongdoing,” John Holcomb, MD, chair of TMA’s Select Committee on Medicaid, CHIP and the Uninsured, wrote. Without due process protections and other important changes in the draft rules, Dr. Holcomb wrote, “the pervasive fear among physicians that they will be incorrectly accused of fraud, waste, or abuse, or denied meaningful recourse in a fraud investigation will continue to contribute to the decline in physician participation in Medicaid.”

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