Bill > HR1784

This bill aims to strengthen Medicare fraud prevention by introducing several key provisions. First, it mandates the deactivation of National Provider Identifiers (NPIs) for healthcare providers and entities excluded from federal healthcare programs, ensuring that organizations that have been sanctioned cannot continue to bill Medicare. Second, the bill requires Medicare Advantage plans to include the NPI of providers who order or refer specific designated items and services (such as durable medical equipment, diagnostic tests, and home health services) in their encounter data, with claims being rejected if this information is missing or invalid. Third, the bill introduces a new requirement for telehealth services, requiring physicians and practitioners with employment or contractual relationships with telehealth companies to include a specific claims modifier when billing for telehealth services. This modifier will help identify the relationship between telehealth suppliers and telehealth companies, potentially making it easier to track and prevent fraudulent billing practices. The overall goal of these provisions is to increase transparency, improve oversight, and reduce waste, fraud, and abuse in the Medicare system by creating more robust identification and tracking mechanisms for healthcare providers and services.

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https://www.congress.gov/bill/119th-congress/house-bill/1784/all-info