Can a Withdrawn Rule Really Hurt Anti-Fraud Efforts?


It’s common for new presidents to withdraw pending rules before they’re published in the Federal Register, review them and then decide whether to re-issue them. But when it comes to health-care fraud, this might not be the best idea, and could harm anti-fraud efforts, sources told me. The Trump administration Jan. 27 withdrew a final rule that would have strengthened provider enrollment in Medicare and Medicaid.

The final rule would have required providers to disclose any affiliations with physicians who had been excluded or had their payments suspended by Medicare or Medicaid, among other provisions. Currently excluded providers can find ways to continue making money from Medicare by using a front person to start a new company or affiliating with someone who's able to bill Medicare, Louis Saccoccio, the chief executive officer of the National Health Care Anti-Fraud Association, told me.

The rule would have blocked these arrangements, Saccoccio said, as well as arrangements in which providers refused to repay debts to Medicare or Medicaid but still profited from the program through relationships with doctors who had billing privileges.

While it’s possible the final rule will be released at a later date, that likelihood decreased after President Trump signed an executive order intended to limit regulations, Linda Baumann, an attorney with Arent Fox, told me. The so-called “two-for-one” order requires agencies to eliminate two existing regulations for every new regulation they issue.

Baumann said she anticipated the Trump administration wouldn't resubmit the final rule in the near future because of its projected cost, as well as the need to repeal two existing regulations upon resubmission. The proposed rule is slated to cost $298.8 million per year for the first three years of implementation, which is a lot of money to offset through the elimination of existing regulations, she said.

Read my full story here.

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