AHA responds to CMS’ CRUSH RFI on potential actions addressing fraud in health care

The AHA today responded to a Centers for Medicare & Medicaid Services request for information on its Comprehensive Regulations to Uncover Suspicious Healthcare, or CRUSH, initiative. The RFI seeks stakeholder feedback on potential regulatory changes that might be included in a potential future CRUSH proposed rule, as well as other programmatic changes that could be implemented to combat fraud, waste and abuse in federal health care programs. The AHA urged CMS to ensure that any such changes are appropriately data-driven and do not add unnecessary administrative burden for hospitals. The AHA encouraged CMS to increase federal oversight and scrutiny of certain Medicare Advantage Organization coverage and reimbursement practices. Additionally, the AHA recommended that CMS leverage and strengthen its existing oversight tools, processes and transparency requirements in Medicaid and the Children’s Health Insurance Program and offered strategies to support the responsible use of artificial intelligence to mitigate fraud, waste and abuse.