# Medicare Fraud Detection and Deterrence Act of 2023

This bill is designed to make it harder for fraudsters to cheat Medicare and to give the government better tools to catch them. It does this by creating new tracking requirements and identification systems that follow the money and the providers involved in Medicare claims.

The bill has three main parts. First, it requires the government to automatically shut down the identification numbers (called National Provider Identifiers) of doctors, clinics, and suppliers who have been kicked out of Medicare for fraud or abuse. Think of it like revoking a driver's license—if someone is banned from Medicare, their official ID number gets deactivated so they can't submit claims. This ID gets turned back on only when their exclusion ends. Second, the bill requires Medicare Advantage plans (the private insurance plans that many seniors use instead of traditional Medicare) to include the provider's identification number when they report which doctors ordered tests, equipment, or referrals for patients. This creates a clear paper trail showing who ordered what, making it easier to spot suspicious patterns. The government can reject any claim that doesn't include this information or includes an invalid provider ID. Third, the bill requires telehealth companies—those online doctor visit platforms—to use a special code on their claims to identify when a doctor is working for a telehealth company rather than having their own independent practice. This helps investigators spot potential fraud schemes where telehealth companies might be steering patients to unnecessary services.

Overall, this bill makes Medicare's record-keeping more transparent and creates more accountability checkpoints. For most seniors and legitimate healthcare providers, this shouldn't change anything about their care. But for anyone trying to commit fraud, it significantly increases the risk of getting caught.

Medicare Fraud Detection and Deterrence Act of 2023

Doggett, Lloyd

Medicare Fraud Detection and Deterrence Act of 2023 This bill requires the Centers for Medicare &amp; Medicaid Services (CMS) to deactivate the standard unique health identifiers of health care providers that are excluded from federal health care programs because of fraud, waste, or abuse. The bill also requires (1) any data submitted by Medicare Advantage plans with respect to durable medical equipment, prosthetics or orthotics, laboratory tests, imaging tests, or home health services to include the standard unique health identifier of the associated provider or supplier; and (2) health care practitioners who are employed by or contract with telehealth companies to use a specialized claims modifier (developed by CMS) for Medicare telehealth services.