CMS Plans to Share MDS Info with Health Plans

In an effort to fight fraud, CMS plans to share provider-specific MDS information with health plans. The MDS is one of 23 records systems affected by the new "routine use" defined by CMS.

According to CMS, sharing this information is meant to "prevent, deter, discover, detect, investigate, examine, prosecute, sue with respect to, defend against, correct, remedy or otherwise combat fraud, waste or abuse in such programs."

This sharing would, for example, show if a scammer is billing multiple insurance providers for a full day's worth of care on the same day.

Disclosures would be coordinated by the Data Sharing Partnership Group of CMS.

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