MATCH OBJECTIVE. Under this matching program, VA internal and external providers will be matched against the database of Medicare providers and suppliers who have been revoked by CMS pursuant to 42 C.F.R. § 424.535. VA will perform additional validations/investigations to determine if providers and suppliers are in compliance with VA program requirements. VA will take appropriate action or refer cases to OIG for action.
MATCH OBJECTIVE. Under this matching program, identifying information about currently enrolled Medicare providers and suppliers will be matched against data from one or more of the Privacy Act- protected data sources (also known as “restricted data sources”) in Treasury’s Do Not Pay Working System to detect providers and suppliers who are identified in that system as ineligible to receive federal payments or awards. CMS will use the information to determine whether those providers and suppliers are ineligible to be actively enrolled in Medicare and subsequently bill Medicare and, if so, to take prompt actions to suspend or revoke their Medicare billing privileges pursuant to 42 CFR § 424.535. The matching program enables CMS to detect and prevent fraud, waste, abuse and avoid making future improper payments to disqualified providers and suppliers, and might also enable recoupment of past payments made to those providers and suppliers; lessens financial costs and administrative burdens for CMS by providing an efficient means of detection; and, most importantly, enhances patient safety for beneficiaries in CMS programs. This matching program will provide CMS with prompt access to up to date, authoritative information from multiple federal agencies under one matching agreement with Fiscal Service, eliminating the need to manually compare files or to execute separate matching agreements with multiple agencies.
