Monitor Mondays
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Monitor Mondays
CMS Launches CRUSH: A New Anti-Fraud Program
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The Centers for Medicare & Medicaid Services (CMS) has launched a new initiative titled Comprehensive Regulations to Uncover Suspicious Healthcare (CRUSH).
CRUSH is a sweeping fraud prevention program. In an official news release posted Thursday, CMS reported suspending $5.7 billion in suspected fraudulent Medicare payments, preventing $1.5 billion in DMEPOS (Durable Medical Equipment, Prosthetics, Orthotics, and Supplies) billing, revoking more than 5,500 providers’ billing privileges, and denying 122,000 claims that failed medical necessity checks.
This latest news, including a nationwide DMEPOS enrollment moratorium and a $259.5 million Medicaid funding deferral, signals a decisive shift toward real-time enforcement.
What does CRUSH mean for providers, revenue cycle leaders, and compliance teams?
Senior healthcare consultant Penny Jefferson will be the special guest during the next live edition of the long-running news and information national podcast Monitor Mondays. Jefferson, the director of clinical documentation integrity (CDI) services for the University of California Davis Medical Center, will report on this new and developing story.
The broadcast will also include these instantly recognizable features:
- Monday Rounds: Ronald Hirsch, MD, vice president of R1 RCM, will be making his Monday Rounds.
- The RAC Report: Healthcare attorney Knicole Emanuel, partner at the law firm of Nelson Mullins, will report the latest news about auditors.
- Risky Business: Healthcare attorney David Glaser, shareholder in the law offices of Fredrikson & Byron, will join the broadcast with his trademark segment.
- Legislative Update: Adam Brenman, senior legislative affairs liaison for Zelis, will report on current healthcare legislation.
