Thoughts on Healthcare Markets & Technology
Thoughts on Healthcare Markets & Technology Podcast
CMS-1844-P, Home Health Fraud, and the Founder Opportunity: How Retroactive Revocations and Geographic Saturation Rules Turn Medicare Program Integrity Into a Buildable Market
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CMS-1844-P, Home Health Fraud, and the Founder Opportunity: How Retroactive Revocations and Geographic Saturation Rules Turn Medicare Program Integrity Into a Buildable Market

CMS quietly dropped a rule on July 1 that changes the math on Medicare fraud enforcement. It is dressed as a home health payment update. It is not.

The big move: all revocation grounds become retroactive to when noncompliance started. Today, bad actors keep money already billed. Under the new rule, every dollar during a noncompliant period is recoverable…

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